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OBM Geriatrics

(ISSN 2638-1311)

OBM Geriatrics is an Open Access journal published quarterly online by LIDSEN Publishing Inc. The journal takes the premise that innovative approaches – including gene therapy, cell therapy, and epigenetic modulation – will result in clinical interventions that alter the fundamental pathology and the clinical course of age-related human diseases. We will give strong preference to papers that emphasize an alteration (or a potential alteration) in the fundamental disease course of Alzheimer’s disease, vascular aging diseases, osteoarthritis, osteoporosis, skin aging, immune senescence, and other age-related diseases.

Geriatric medicine is now entering a unique point in history, where the focus will no longer be on palliative, ameliorative, or social aspects of care for age-related disease, but will be capable of stopping, preventing, and reversing major disease constellations that have heretofore been entirely resistant to interventions based on “small molecular” pharmacological approaches. With the changing emphasis from genetic to epigenetic understandings of pathology (including telomere biology), with the use of gene delivery systems (including viral delivery systems), and with the use of cell-based therapies (including stem cell therapies), a fatalistic view of age-related disease is no longer a reasonable clinical default nor an appropriate clinical research paradigm.

Precedence will be given to papers describing fundamental interventions, including interventions that affect cell senescence, patterns of gene expression, telomere biology, stem cell biology, and other innovative, 21st century interventions, especially if the focus is on clinical applications, ongoing clinical trials, or animal trials preparatory to phase 1 human clinical trials.

Papers must be clear and concise, but detailed data is strongly encouraged. The journal publishes a variety of article types (Original Research, Review, Communication, Opinion, Comment, Conference Report, Technical Note, Book Review, etc.). There is no restriction on the length of the papers and we encourage scientists to publish their results in as much detail as possible.

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Current Issue: 2024  Archive: 2023 2022 2021 2020 2019 2018 2017
Open Access Review

Take a Seat for Yoga with Seniors: A Scoping Review

Diana Veneri 1,*, Mary Gannotti 2

  1. Sacred Heart University 5151 Park Avenue, Fairfield, United States of America

  2. University of Hartford 200 Bloomfield Avenue, Hartford, United States of America

* Correspondence: Diana Veneri

Academic Editor: Marieke Van Puymbroeck

Collection: Yoga in Older Adults

Received: October 07, 2021 | Accepted: May 04, 2022 | Published: May 16, 2022

OBM Geriatrics 2022, Volume 6, Issue 2, doi:10.21926/obm.geriatr.2202197

Recommended citation: Veneri D, Gannotti M. Take a Seat for Yoga with Seniors: A Scoping Review. OBM Geriatrics 2022; 6(2): 197; doi:10.21926/obm.geriatr.2202197.

© 2022 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

Abstract

Chair yoga is a specific form of yoga practiced while seated on a chair, or standing using a chair for support; this adaptation allows those with impaired standing ability to practice safely. The purpose of this scoping review was to analyze the published literature regarding the use of chair/adapted yoga with older adults. Two researchers performed the review. Data sources: PubMed Central, CINAHL, Medline Full Text, Nursing and Allied Health, SPORT discus and TRIP were accessed. Study selection: Inclusion criteria included pre-test/post-test studies with a yoga intervention for older adults using a chair. Exclusion criteria were studies with seated exercise interventions not specific to yoga, mindfulness or breathing techniques with no physical activity, yoga with no use of a chair, not specific to older adults and reviews. The search strategy was performed by two reviewers. Data extraction: Covidence, a systematic review production tool, was utilized to aid article analysis. Data synthesis: Summation of study type, sample, dosing, intervention type, setting, outcome domains and results were included. Of the 3147 studies initially identified, 75 met the inclusion criteria. This review included 32 RCTs, 11 quasi-experimental, 21 cohort, nine qualitative studies and 2 case-series studies. Most studies reported affective and psychomotor domains of learning (n = 51) and favored chair/adapted yoga as an intervention over the control. A few studies included a second intervention. Twenty two of the 75 studies were focused on community dwelling older adults, followed by participants with orthopedic diagnoses (n = 16), and cognitive impairment (n = 9). The quality of literature supporting chair/adapted yoga is fairly substantial for both community dwelling and those with certain physical and cognitive diagnoses. It is recommended that this intervention continue to be utilized and studied.

Keywords

Chair yoga; older adults; bloom’s learning domains function

1. Introduction

Healthcare practitioners have studied complementary and integrative health across a wide range of ages, diagnoses, physical and mental impairments [1]. Considering the International Classification of Functioning, Disability and Health (ICF) model, healthcare practitioners are drawn to yoga because of its multifaceted approach. Yoga improves physical capacity like other forms of exercise, but offers a spiritual component as well. Breathwork and meditation have been proven to promote relaxation, decrease stress with demonstrated improvements at the physiological levels [2,3,4,5,6]. The ICF is a framework for describing and organizing information, providing a standard language and a conceptual basis for the definition and measurement of health and disability. The three domains of the ICF include body structure and function, activity and participation [7]. The practice of yoga has demonstrated improvements across all three of these domains [8,9,10,11,12,13]. The body of knowledge has grown sufficiently enough to support the rigour of systematic reviews and meta-analyses [14,15,16]. In 2013, McCall published an overview of systematic reviews of yoga as an intervention with adults with acute and chronic health conditions including pain, psychiatric and psychological disorders and various forms of arthritis [17]. There were 13 studies with quantitative data included in the analysis and 16 reported health conditions. The findings were that the quality of the literature was high but the support for the yoga intervention was low, similar to the findings of others [1,11,14,18]. Researchers are beginning to explore complementary and integrative methods to not only treat certain conditions and diagnoses, but also to optimize the physical and mental well-being of the healthy population.

Chair yoga is a specific form of yoga practiced while sitting on a chair, or standing using a chair for support. The poses are often adaptations of asanas in modern yoga as exercise [19]. The use of a chair allows those with impaired ability to stand or impaired standing balance to perform yoga safely. It has been used with pediatric populations, those with stroke, intellectual disabilities, multiple sclerosis, lower limb amputation, Parkinson’s, breathing impairment, arthritis, cancer and psychiatric disorders as both a exercise modality and adjunct to therapy [20,21,22,23,24]. In a 2016 study with 108 community dwelling, sedentary older adults, it was determined that adapted yoga was more amenable to conventional exercise because it required less equipment and was more easily adapted [25].

A review of the literature has yet to be performed with chair yoga as the topic. This scoping review seeks to answer the question “What is known from existing empirical literature about chair yoga used therapeutically with older adults?” The review’s objectives are to explore the breadth and extent of the evidence, map and summarize the evidence, and identify knowledge and research gaps in this evidence.

2. Materials and Methods

2.1 Data Sources and Searches

The search strategy for this review was developed in consultation with the College of Health Profession’s experienced librarian. The search was conducted in the months of November and December of 2021 by two researchers; the search terms used were “chair yoga AND older adult,” “chair yoga OR adapted yoga AND older adult* OR elderly* OR senior* OR geriatric*” “adaptive yoga AND older adult* OR elderly* OR senior* OR geriatric*”and “modified yoga AND older adult* OR elderly* OR senior* OR geriatric.*” When available, search limits were set to include peer-reviewed, English language with the dates of 2011-2021. Databases included in the search strategy were PubMed Central, MEDLINE Full Text, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Nursing and Allied Health, SPORT discus and TRIP.

2.2 Study Selection

Studies were included if they met the following criteria: (1) research included subject populations who were older adults, defined as 50 years of age or greater; and (2) pre-test/post-test design studies using chair or adapted yoga that targeted the psychomotor domain and recorded outcome measures; and/or (3) pre-test/post-test design studies using chair or adapted yoga that targeted the cognitive domain and measured outcomes; and/or (4) pre-test/post-test design studies using chair or adapted yoga that targeted the affective domain and measured outcomes. However, studies were excluded from analysis if: (1) the subject population were adults less than 50 years of age; (2) the seated exercise was not specific to yoga; (3) mindfulness or breathing techniques did not include physical activity; (4) a chair was not used as a modification; (5) were published in a language other than English; (6) populations were not exclusive to older adults and included other ages groups; (7) were a published study protocol without results; (8) were published before January 2011; (9) were not peer reviewed; (10) the design was a review of any type or (11) were opinion or perspective papers.

Covidence, a systematic review production tool, was utilized to aid article analysis. The search results were exported to Covidence and duplications were automatically removed. Two reviewers independently analyzed article titles and abstracts to determine their eligibility using the inclusion criteria. If deemed eligible by both reviewers, the full text of the article was then considered. A study was excluded when the reviewers agreed to exclude the article for the same reason. Discrepancies between reviewers regarding article eligibility were resolved through discussion. Full text articles were read of those meeting the inclusion criteria. Refer to Figure 1 for the search result (PRISMA). There were 75 studies included in the analysis.

Click to view original image

Figure 1 PRISMA Flow Chart: Chair/adapted yoga and older adults 2020-2-21 search.

2.3 Data Synthesis and Analysis

Determining the study type and which Bloom’s learning domains (psychomotor, cognitive and affective) were measured by each study’s outcome measures was part of the review process. Oxford’s Level of Evidence was used to numerically code study design type: “1” for randomized control trials (RCT), “2” for cohort and quasi-experimental, “3” for case-control and “4” for case/case-series and qualitative [26]. The authors extracted study details of each to populate the tables. Table 1 lists study title, journal, author and country. Subsequent tables are organized according to study type and level of evidence. Table 2 consists of large RCTs, operationally defined as studies with greater than 50 participants. Table 3 consists of medium and small RCTs, defined as those with >20 and <50 and ≤ 20 participants, respectively. Table 4 lists quasi-experimental and cohort studies, and Table 5 includes qualitative and case-series studies; both tables are further categorized using the operational definitions for study size. Data extracted from each article included first author and year, study purpose, participants, diagnoses, sample size, setting, group allocation, methods, outcome measures, results, discussion and effect. Also included in each table was classification of the outcome measures using Bloom’s taxonomy of affective, psychomotor and/or cognitive domains.

Table 1 All studies included in the review.

Table 2 Large RCTs.

Table 3 Medium-sized and Small RCTs.

Table 4 Quasi-Experimental and Cohort Studies.

Table 5 Qualitative and Case Series Studies.

3. Results

The search yielded 3147 titles, Covidence removed 140 duplications. An additional 2730 articles were removed via screening of the titles and abstracts, leaving 277 full text articles for consideration. Upon further investigation 66 quantitative and 9 qualitative studies met the inclusion criteria. Frequency counts of summary statements are provided for the data columns in Tables 2-5. Of the 75 studies, 26 were published in complementary therapy/yoga journals, 20 in geriatric journals, 13 in physical therapy journals, three in cancer journals, two in orthopedic/pain journals and 11 in general journals, including two dissertations. This review included 32 RCTs, 13 large, 14 medium and five small. There were three large, five medium and three small quasi-experimental, six medium and 15 small cohort studies. There were three large, two medium and four small qualitative studies and 2 case-series studies.

3.1 Participants

There were 2964 participants among the 75 studies. The median sample size was 25.5 (range 3-131); the mean sample size was 40. One study had three participants who were not grouped together [98], 28 studies had one group with chair/adapted yoga as the intervention [22,23,24,32,63,70,72,73,75,76,77,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,96], 38 studies had two groups [25,27,28,30,31,32,34,36,37,38,40,41,42,43,44,45,46,48,49,50,51,52,53,54,56,57,58,59,60,61,62,64,66,67,71,78,90] and 8 studies had three groups [29,35,39,47,55,65,69,94,97]. If a study had two groups, the second group served as a control, typically either waitlist or education [25,27,28,30,31,32,34,36,37,38,40,41,42,43,44,45,46,48,49,50,51,52,53,54,56,57,58,59,60,61,62,64,66,67,71,78,90]. If there were three groups, a second intervention was compared to chair yoga; interventions included Reiki, chair exercise, resistance training or tai chi [29,35,39,47,55,65,69,94,97] One study categorized the three groups according to pain site and type, with all of the participants receiving the same intervention [69]. The majority of the studies (n = 46) included participant sex as part of the demographic profile; 29 studies did not. Fifteen studies included only females [28,36,39,46,48,49,52,55,61,62,71,83,84,90,94] and one study included only males [70]. Ten studies had 1-24% males [25,27,28,39,51,64,65,73,89,92], another 10 had 25-49% males [25,34,38,58,69,73,74,92,95,97] and 10 studies had greater than 50% males as participants [27,29,32,53,54,60,76,89,92,93]. All of the study participants were older adults, 11 studies did not report additional age information [37,46,52,57,68,86,88,90,91,97,99]. Six studies provided an age range [28,35,41,77,94,95], seven studies included participants with a mean age 50-59 years [36,51,66,67,69,80,83], 19 studies with a mean age of 60-69 [25,40,42,43,48,50,56,59,63,70,71,73,81,84,85,87,93], 21 studies with a mean age of 70-79 [22,27,29,30,32,33,34,38,39,46,53,54,55,58,60,72,75,76,79,82,96] and 10 studies included participants with a mean age greater than 80 years [44,47,49,61,62,64,65,74,78,92]. The majority of these studies, 22 [29,33,35,38,41,44,45,50,51,52,59,62,64,71,73,75,76,78,79,80,84,90] of 75, were focused on community dwelling older adults, 11 of which were healthy. Orthopaedic diagnoses (n = 16), and cognitive impairment (n = 9) [37,39,47,60,68,88,92,96,97] accounted for the next largest diagnostic categories. The orthopaedic diagnoses were lower extremity osteoarthritis (n = 13) [22,25,27,28,30,31,32,34,46,53,65,66,95], vertebral impairments (n = 2) [55,72] and osteopenia (n = 1) [48]. The remaining diagnostic categories include cardiopulmonary disorders (n = 5) [42,43,57,93,98], neurologic disorders (n = 7) [40,56,80,82,85,87,89], cancer (n = 8) [36,63,67,70,81,83,86], institutionalized [49,61,77,94] and chronic pain (n = 2) [69,74]. The remaining three studies included participants with a history of falls, insomnia or veterans [54,58,91].

3.2 Dosing and Intervention

The duration of each intervention session ranged from 15-120 minutes, with 10 having sessions 30 minutes or less [36,37,43,47,50,66,67,77,92,94], 15 with 45-minute sessions [22,27,30,31,33,34,35,39,54,64,65,86,88,89,96], 25 with 50- 60-minute sessions [25,28,41,45,46,48,49,51,52,53,55,57,59,60,68,69,71,73,74,75,76,84,85,87,93], and 16 with > 60-minute sessions [29,31,38,42,44,52,56,62,70,78,79,80,81,83,90,95] and another 9 were unspecified [40,58,61,63,82,91,97,98]. Forty of the studies held intervention sessions twice weekly [22,27,30,32,33,35,37,39,40,41,47,49,51,52,53,57,61,62,63,64,65,68,70,73,75,77,78,79,80,81,82,83,84,85,88,90,92,93,94,95], two met 2-3 times a week [49,91], 19 studies met once per week [29,31,35,38,42,43,44,46,50,55,56,57,66,69,74,76,86,87,89], most of which were supplemented with a home program, 11 met three times per week [25,28,36,48,54,59,60,67,71,72,84], and three were unspecified [63,96,98]. Study intervention durations ranged from six weeks to 18 months; the most common duration was eight weeks (n = 31) [22,25,27,30,32,33,34,36,40,42,44,45,46,50,52,53,63,64,65,67,68,73,76,78,80,81,82,86,87,89,90], followed by 12 weeks (n = 19) [31,37,38,39,43,48,51,54,57,58,60,62,66,79,83,85,88,93,96] and 10 weeks (n = 6) [41,55,69,74,77,92]. Chair yoga interventions were described as including breathwork, meditation and yoga with the participant seated in a chair; some interventions identified specific yoga styles, with hatha as the most common. Ten study interventions encouraged/included a home exercise program as part of the protocol [29,44,45,46,56,57,67,76,81,90].

3.3 Setting

Fifty-six studies were conducted in the United States [22,27,28,29,30,32,33,34,35,40,41,42,43,44,45,46,51,52,53,54,57,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,95,96,97,98], two studies in the countries of Germany [36,50], Portugal [49,61], Australia [47,56], Sweden [55,93], Taiwan [60,62] and Thailand [48,71]. One study was conducted in the countries of the Czech Republic [31], Japan [37], the United Kingdom [38] New Zealand [94], Indonesia [59], Greece [39], and Israel [58]. Studies were primarily conducted across community centers (n = 21) [27,30,31,32,34,35,38,39,41,49,50,53,56,57,61,62,64,65,66,79,95], hospital facilities (n = 25) [37,42,43,44,47,58,60,63,67,68,69,70,73,74,76,77,78,81,86,89,91,92,93,94] and universities (n = 23) [22,25,29,36,40,45,46,48,51,52,54,59,71,72,75,80,82,83,84,85,87,90,97], two university community facilities [28,55], one community hospital [96], one academic hospital [98] and two settings were unspecified [33,88].

3.4 Bloom’s Learning Domains

Seventy of the 75 studies included some measure of psychomotor function. Types of measures were highly varied among studies spanning from physiologic and impairment to functional to fitness performance measures. There was no single outcome measure common among studies. The most common impairment measured was balance via the Berg Balance Scale, followed by the Functional Reach and Single Limb Balance Tests. Gait was the most common functional activity measured using the Timed Up and Go Test, 6 Minute Walk Test and other gait assessments for speed and endurance. Self-reported measures were used for pain, fatigue and dyspnea, sleep, fragility and arthritis symptoms. The Western Ontario and McMaster University Osteoarthritis Index was the most prevalently used measure for osteoarthritis.

Measures of affect were reported in 57 of the 75 studies. Measurement included the qualities of anxiety, stress, mood, fatigue, life satisfaction, morale, well-being, self-compassion, self-esteem, self-efficacy, depression, anger, personality and quality of life. These measures were self-report. Some measures were quality-specific, but also were varied amongst the studies. Moss conducted a RCT to examine the feasibility and effectiveness of a mindfulness-based stress reduction program on 39 elders in a continuing care community. The chair yoga group practiced for 120 minutes once per week, supplemented with 25-30 minutes of daily exercise for eight weeks. The intervention group showed significant improvement in acceptance and psychological flexibility and in role limitations due to physical health and verbally reported increased awareness, less judgement, and greater self-compassion compared to the control group [44]. Toise also conducted an RCT to examine the feasibility and effectiveness of a chair yoga program for patients with implantable cardiac defibrillators. Total shock anxiety and anxiety significantly decreased for the yoga group, but increased for the control group. Compared to the control, the yoga group had greater overall self-compassion and greater mindfulness. Exploratory analyses utilizing a linear model (R2 = 0.98) of observed device-treated ventricular (DTV) events revealed that the expected number of DTV events in the yoga group was significantly lower than in the control. AY had a 32% lower risk of experiencing device-related firings at the end of follow-up compared to the control group [42].

3.5 Affective, Cognitive and Psychomotor Learning Domains

There was one study in which all three learning domains were addressed by the outcome measures. Oken conducted a study to determine the effect of yoga on cognitive function, fatigue, mood, and QoL in seniors. There were no effects on cognitive and alertness measures, but adapted yoga improved physical and QoL measures compared to exercise and control [29].

3.6 Affective and Psychomotor Learning Domains

Of the 51 studies with both affective and psychomotor outcome measures, large studies included nine RCTs [27,29,31,32,33,34,36,37,38], two quasi-experimental [58,60] and two qualitative studies [90,91]; these studies were predominantly conducted with patient populations of community dwelling older adults with lower extremity osteoarthritis and determined that chair yoga can reduce pain, improve mood but had no impact on frailty measures [27,32,33,36] Several of these studies were conducted in community-based facilities, senior housing, university and medical centers. One of the qualitative studies found that delivering adapted yoga to a wide range of patients within a healthcare setting appears to be feasible and acceptable. These results were the same for either delivery mode, in-person or telehealth, with participants reporting high levels of satisfaction and improvement in multiple problem areas [94].

Studies of moderate size included 11 RCTs [39,40,41,43,45,46,47,49,50,51,52], five quasi-experimental [61,62,63,64,65,66], four cohort [69,70,73,74] and two qualitative studies [92,93] Populations included sedentary older adults and community dwellers, COPD, knee osteoarthritis, chronic stroke and frail adults with impaired cognition. Study sites included community centers, universities and outpatient clinics/hospitals.

Three RCTs [55,56,57], one quasi-experimental [67], eight cohort [77,80,83,84,86,87,88,89] four qualitative [94,95,96,97] and two case series studies [22,98] were small. Sites included universities, community and cancer centers. Study populations included lower extremity cancer, osteoarthritis, community dwellers, Alzheimer’s, pulmonary hypertension and COPD, neurologic disorders and impaired cognition.

3.7 Cognitive and Psychomotor Learning Domains

Of the 75 studies, there were nine that specifically targeted older adults with dementia/Alzheimer’s [37,39,47,60,68,88,92,95,96] Only two studies reported using a cognitive measure [39,95], and another measured dementia quality of life [47] One study reported both psychomotor and cognitive measures [39]. In this RCT of 49 women with mild cognitive impairment, it was determined that the resistance group had better results than the chair yoga group and that the chair yoga group had better results than the control group. The interventions were provided twice weekly for 12 weeks. The authors suggest a longer study duration in future research.

3.8 Psychomotor-only Learning Domain

Seventeen studies used only psychomotor outcome measures. There were three large [25,28,30], one medium [48] and two small RCTs [53,54], one large [59] and two small quasi-experimental [66,68] and eight small cohort studies [71,72,75,76,78,79,82] McCaffrey, 2019 compared chair yoga with chair exercise in a small RCT of 18. Both groups had significant increases in the TUG and WOMAC, with no differences between groups [68].

3.9 Affective-only Learning Domain

There were five studies reporting outcome measures pertaining to the affective learning domain; study types included one large and two medium RCTs, one small cohort and one large qualitative study. Bonura conducted a large RCT to assess the effect of chair yoga on the psychological health of older adults. Chair yoga improved more than the other two groups in anger, anxiety, depression, well-being, self-efficacy and self-efficacy for daily living [35]. Similar results were found with the other studies with community dwelling, implantable cardiac defibrillator, and veterans [42,44,63,81].

4. Discussion

The results of this scoping review support the use of chair/adapted yoga as an intervention for older adults; the majority of the studies had positive, if not significant results. Studies investigating chair/adapted yoga as an intervention for older adults consist of fairly robust study design, with RCTs and cohort studies predominating. That said, most of these studies compared chair/adapted yoga to a control group rather than another intervention and ten included follow-up data collection [27,30,32,34,35,37,42,45,46,64] Of the 75 studies included in this review, 15 reported follow-up. [27,30,32,34,35,37,42,45,46,64,68,74,80,83,95].

Seniors of all ages from 50 to 80+ participated in chair yoga programs. The most common dose was 2x/week for 8 weeks for 50-60 minutes. The majority of the interventions were performed in community, university and hospital settings. The body of literature represents participants from the continents of North America, Europe, Asia, and Australia. Generally speaking, the findings of this study are consistent with previous reviews and meta-analyses; yoga can have a positive impact on psychomotor, affective and cognitive domains. Of these reviews, five were exclusive to yoga [16,17,99,100,101], while the others included other mind-body, breathing and exercise interventions for adults and children [1,2,3,5,6,18] The review by McCall involved older adults with acute and chronic health conditions, the review by Sivaramakrishnan involved older adults and Sieczkowska’s review was focused on those with rheumatic arthritis. Both meta-analyses demonstrated support for yoga as an intervention with large effects for emotional, social, health and physical function; neutral support for mental health, pain and vitality [16,17,101]. While none of these reviews were exclusive to chair/adapted yoga, some of the studies in this current review were included in those previous [25,35,39,46,47,49,51,56,65,66,72].

The affective and psychomotor domains of learning are well represented among the outcome measures across these studies. It has been demonstrated that the intervention of chair/adapted yoga has the capacity to improve physical impairments, functional mobility and capacity, affective characteristics such as mood, sleep and stress as well as social aspects including quality of life and life satisfaction. Though not extensively studied, there exists no support that yoga has the capacity to improve cognitive function However, chair/adapted yoga can improve the physical and affective aspects of someone with impaired cognitive function [37,47,60]. The findings suggest that yoga can be used to complement traditional medical and therapy interventions and, in many cases, has already done so [32,37,47,68,96]. With the rising costs of healthcare and the reduction in traditional therapy services, chair/adapted yoga has been demonstrated to be a feasible and acceptable form of treatment for the older adult population. Physical and occupational therapists should continue to partner with yoga instructors to bring chair/adapted yoga to community-based settings. Chair/adapted yoga can be performed both by patients and their caregivers alike, thereby offering an activity that both can experience together.

The literature included in this review spans more than ten years and sufficiently provides evidence of its use with a variety of diagnoses, as well as community dwelling well-elders. Further study should explore additional patient diagnoses including neurologic, orthopedic, and cardiopulmonary. While knee osteoarthritis has been extensively studied, disorders of the shoulder have not. The neurologic diagnosis of stroke, Parkinson’s disease and dementia/Alzheimer’s have received some attention from chair/adapted yoga, while other diagnoses such as multiple sclerosis, spinal cord injury and traumatic brain injury have not. Future research should consider introducing a second intervention to better understand the comparison of yoga with other exercise forms or therapy interventions to determine if it could sufficiently be substituted or used as an adjunct. Standardizing chair/adapted yoga interventions as per diagnostic population may also be of interest to future researchers/practitioners. This would include research to determine the best frequency, intensity and time (FIT) prescription. Given the ramifications of the current pandemic, work to explore delivery modes should also continue; two studies included in this review have investigated use of telehealth [91] and digital video disc [36]. Studies with more follow-up are also recommended.

4.1 Limitations

This scoping review was limited to chair/adapted yoga for older adults. There may be other types of yoga interventions used with older adults, not included in this review. Meditation, yoga nidra, Ayurveda are other yoga practices that were omitted from this review that could potentially benefit this population. This review excluded literature pertaining to traditional yoga practice. Furthermore, this review was intentionally limited by date to reflect current literature of the past 10 years. It is possible that there is additional evidence to support chair/adapted yoga preceding this time frame. This study did not include those that were not peer-reviewed or in the English language. A meta-analysis to statistically determine the effects of chair/adapted yoga to enhance physical and/or affective function was not performed, but could be done in the future.

5. Conclusions

The quality of literature supporting chair/adapted yoga is fairly substantial as evidenced by RCTs, quasi-experimental and cohort study types. The evidence to support chair/adapted yoga as an intervention for older adults is relatively also substantial, both community dwelling and those with certain physical and psychological diagnoses. It is recommended that this intervention continue to be utilized and studied with this population.

Acknowledgments

The author would like to acknowledge Geoffrey Staysniak, the reference librarian consulted on the search technique used for this review.

Author Contributions

Dr. Veneri, primary researcher, is responsible for the study design, search and review of the literature, data extraction and analysis, and is the primary author. Dr. Gannotti, second researcher, is responsible for search and review of the literature, data extraction and analysis.

Competing Interests

The authors have declared that no competing interests exist.

References

  1. Anderson JG, Rogers CE, Bossen A, Testad I, Rose KM. Mind–body therapies in individuals with dementia: An integrative review. Res Gerontol Nurs. 2017; 10: 288-296. [CrossRef]
  2. Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, et al. How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci. 2018; 12. doi: 10.3389/fnhum.2018.00353. [CrossRef]
  3. Jayawardena R, Ranasinghe P, Ranawaka H, Gamage N, Dissanayake D, Misra A. Exploring the therapeutic benefits of pranayama (yogic breathing): A systematic review. Int J Yoga. 2020; 13: 99-110. [CrossRef]
  4. Chung AMJ, Harvey LA, Hassett LM. Do people with intellectual disability use Nintendo Wii when placed in their home as part of a physiotherapy program? An observational study. Disab Rehabil Assist Technol. 2016; 11: 310-315.
  5. Auty KM, Cope A, Liebling A. A systematic review and meta-analysis of yoga and mindfulness meditation in prison. Int J Offender Ther Comp Criminol. 2017; 61: 689-710. [CrossRef]
  6. Breedvelt JJF, Amanvermez Y, Harrer M, Karyotaki E, Gilbody S, Bockting CLH, et al. The effects of meditation, yoga, and mindfulness on depression, anxiety, and stress in tertiary education students: A meta-analysis. Front Psychiatry. 2019; 10: 193. [CrossRef]
  7. WHO | International Classification of Functioning, Disability and Health (ICF) [Internet]. WHO. 2001 [cited date 2017 January 29]. Available from: https://www.who.int/classifications/icf/en/.
  8. Salgado BC, Jones M, Ilgun S, McCord G, Loper Powers M, van Houten P. Effects of a 4-month Ananda yoga program on physical and mental health outcomes for persons with multiple sclerosis. Int J Yoga Therap. 2013: 27-38. [CrossRef]
  9. Dinesh T, Gaur G, Sharma V, Madanmohan T, Harichandra Kumar K, Bhavanani A. Comparative effect of 12 weeks of slow and fast pranayama training on pulmonary function in young, healthy volunteers: A randomized controlled trial. Int J Yoga. 2015; 8: 22-26. [CrossRef]
  10. de Oliveira G, Tavares M da CCGF, de Faria Oliveira JD, Rodrigues MR, Santaella DF. Yoga training has positive effects on postural balance and its influence on activities of daily living in people with multiple sclerosis: A Pilot Study. Explore. 2016; 12: 325-332. [CrossRef]
  11. Seo DY, Lee S, Figueroa A, Kim HK, Baek YH, Kwak YS, et al. Yoga training improves metabolic parameters in obese boys. Korean J Physiol Pharmacol. 2012; 16: 175-180. [CrossRef]
  12. Doulatabad SN, Nooreyan K, Doulatabad AN, Noubandegani ZM. The effects of pranayama, hatha and raja yoga on physical pain and the quality of life of women with multiple sclerosis. Afr J Tradit Complement Altern Med. 2012; 10: 49-52. [CrossRef]
  13. Hsieh CC, Lin CM, Lai YTL, Yang JC, Huang HL. The effects of yoga exercise invention on quality of sleep and quality of life in stroke patients. Med Sci Sports Exerc. 2016; 48: 606. [CrossRef]
  14. Cramer H, Lauche R, Langhorst J, Dobos G. Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials. Complement Ther Medicine. 2016; 25: 178-187. [CrossRef]
  15. Hourston S, Atchley R. Autism and mind-body therapies: A systematic review. J Altern Complement Med. 2017; 23: 331-339. [CrossRef]
  16. Sieczkowska SM, Casagrande PO, Coimbra DR, Vilarino GT, Andreato LV, Andrade A. Effect of yoga on the quality of life of patients with rheumatic diseases: Systematic review with meta-analysis. Complement Ther Med. 2019; 46: 9-18. [CrossRef]
  17. McCall MC, Ward A, Roberts NW, Heneghan C. Overview of systematic reviews: Yoga as a therapeutic intervention for adults with acute and chronic health conditions. J Evid Based Complement Altern Med. 2013; 2013: 945895. [CrossRef]
  18. Farhang M, Miranda Castillo C, Rubio M, Furtado G. Impact of mind-body interventions in older adults with mild cognitive impairment: A systematic review. Int Psychogeriatr. 2019; 31: 643-666. [CrossRef]
  19. Gendron LM, Nyberg A, Saey D, Maltais F, Lacasse Y. Active mind-body movement therapies as an adjunct to or in comparison with pulmonary rehabilitation for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2018; 10: CD012290. [CrossRef]
  20. Seo JY, Chao YY. Effects of exercise interventions on depressive symptoms among community-dwelling older adults in the United States: A systematic review. J Gerontol Nurs. 2018; 44: 31-38. [CrossRef]
  21. Daugherty B. Chair yoga: Lifespan yoga for health and wellness. Lifespan Yoga; 2015.
  22. Park J PhD, McCaffrey R. Chair yoga: Benefits for community-dwelling older adults with osteoarthritis. J Gerontol Nurs. 2012; 38: 12-22. [CrossRef]
  23. Mascaro JS, Waller AV, Wright L, Leonard T, Haack C, Waller EK. Individualized, single session yoga therapy to reduce physical and emotional symptoms in hospitalized hematological cancer patients. Integr Cancer Ther. 2019; 18: 1534735419861692. [CrossRef]
  24. Bastille JV, Gill-Body KM. A yoga-based exercise program for people with chronic poststroke hemiparesis. Phys Ther. 2004; 84: 33-48. [CrossRef]
  25. Gothe NP, McAuley E. Yoga Is as good as stretching–strengthening exercises in improving functional fitness outcomes: Results from a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2016; 71: 406-411. [CrossRef]
  26. Portney LG. Foundations of clinical research: Applications to evidence-based practice. 4th ed. Philadelphia: F.A. Davis Company; 2020.
  27. Park J, Sherman DG, Agogo G, Hoogendijk EO, Liu Z. Frailty modifies the intervention effect of chair yoga on pain among older adults with lower extremity osteoarthritis: Secondary analysis of a nonpharmacological intervention trial. Exp Gerontol. 2020; 134: 110886. [CrossRef]
  28. Greendale GA, Huang MH, Karlamangla AS, Seeger L, Crawford S. Yoga decreases kyphosis in senior women and men with adult-onset hyperkyphosis: Results of a randomized controlled trial. J Am Geriatr Soc. 2009; 57: 1569-1579. [CrossRef]
  29. Oken BS, Zajdel D, Kishiyama S, Flegal K, Dehen C, Haas M, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med. 2006; 12: 40-47.
  30. McCaffrey R, Park J, Newman D. Chair yoga: Feasibility and sustainability study with older community-dwelling adults with osteoarthritis. Holist Nurs Pract. 2017;31: 148-157. [CrossRef]
  31. Krejci M. Yoga training application in overweight control of seniors with arthritis/osteoarthritis. Fizjoterapia. 2011; 19: 3-8. [CrossRef]
  32. Park J, McCaffrey R, Newman D, Liehr P, Ouslander JG. 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. J Am Geriatr Soc. 2017; 65: 592-597. [CrossRef]
  33. Park J, Liu Z, Vieira ER, Liehr P. Effect of chair yoga on frailty in older adults with lower extremity osteoarthritis: Randomized clinical trial. Innov Aging. 2019; 3: S685. [CrossRef]
  34. Park J, Newman D, McCaffrey R, Garrido JJ, Riccio ML, Liehr P. The effect of chair yoga on biopsychosocial changes in English- and Spanish-speaking community-dwelling older adults with lower-extremity osteoarthritis. J Gerontol Soc Work. 2016; 59: 604-626. [CrossRef]
  35. Bonura KB, Tenenbaum G. Effects of yoga on psychological health in older adults. J Phys Act Health. 2014; 11: 1334-1341. [CrossRef]
  36. Winter Stone KM, Moe EL, Perry CK, Medysky M, Pommier R, Vetto J, et al. Enhancing an oncologist’s recommendation to exercise to manage fatigue levels in breast cancer patients: A randomized controlled trial. Support Care Cancer. 2018; 26: 905-912. [CrossRef]
  37. Ikai S, Uchida H, Mizuno Y, Tani H, Nagaoka M, Tsunoda K, et al. Effects of chair yoga therapy on physical fitness in patients with psychiatric disorders: A 12-week single-blind randomized controlled trial. J Psychiatr Res. 2017; 94: 194-201. [CrossRef]
  38. Tew GA, Howsam J, Hardy M, Bissell L. Adapted yoga to improve physical function and health-related quality of life in physically-inactive older adults: A randomised controlled pilot trial. BMC Geriatr. 2017; 17: 131. [CrossRef]
  39. Karydaki M, Dimakopoulou E, Margioti E, Lyras V, Apostolopoulos X, Papagianni M, et al. Comparison of resistance and chair yoga training on subjective sleep quality in MCI women. Int J Kinesiol Sport Sci. 2017; 5: 26-34. [CrossRef]
  40. Schmid AA, Miller KK, Van Puymbroeck M, DeBaun Sprague E. Yoga leads to multiple physical improvements after stroke, a pilot study. Complement Ther Med. 2014; 22: 994-1000. [CrossRef]
  41. Groessl EJ, Maiya M, Schmalzl L, Wing D, Jeste DV. Yoga to prevent mobility limitations in older adults: Feasibility of a randomized controlled trial. BMC Geriatr. 2018; 18: 306. [CrossRef]
  42. Toise SCF, Sears SF, Schoenfeld MH, Blitzer ML, Marieb MA, Drury JH, et al. Psychosocial and cardiac outcomes of yoga for ICD patients: A randomized clinical control trial. Pacing Clin Electrophysiol. 2014; 37: 48-62. [CrossRef]
  43. Kaminsky DA, Guntupalli KK, Lippmann J, Burns SM, Brock MA, Skelly J, et al. Effect of yoga breathing (pranayama) on exercise tolerance in patients with chronic obstructive pulmonary disease: A randomized, controlled trial. J Altern Complement Med. 2017; 23: 696-704. [CrossRef]
  44. Moss AS, Reibel DK, Greeson JM, Thapar A, Bubb R, Salmon J, et al. An adapted mindfulness-based stress reduction program for elders in a continuing care retirement community: Quantitative and qualitative results from a pilot randomized controlled trial. J Appl Gerontol. 2015; 34: 518-538. [CrossRef]
  45. Hamrick I, Mross P, Christopher N, Smith PD. Yoga’s effect on falls in rural, older adults. Complement Ther Med. 2017; 35: 57-63. [CrossRef]
  46. Cheung C, Wyman JF, Resnick B, Savik K. Yoga for managing knee osteoarthritis in older women: A pilot randomized controlled trial. BMC Complement Altern Med. 2014; 14: 160. [CrossRef]
  47. Saravanakumar P, Higgins IJ, van der Riet PJ, Marquez J, Sibbritt D. The influence of tai chi and yoga on balance and falls in a residential care setting: A randomised controlled trial. Contemp Nurse. 2014; 48: 76-87. [CrossRef]
  48. Phoosuwan M, Yuktanandana P, Kritpet T. The effects of modified yoga pose training on bone remodeling of elderly women with osteopenia. J Exerc Physiol Online. 2021; 24: 25-34.
  49. Marques M, Chupel MU, Furtado GE, Minuzzi LG, Rosado F, Pedrosa F, et al. Influence of chair-based yoga on salivary anti-microbial proteins, functional fitness, perceived stress and well-being in older women: A pilot randomized controlled trial. Eur J Integr Med. 2017; 12: 44-52. [CrossRef]
  50. Bucht H, Donath L. Sauna yoga superiorly improves flexibility, strength, and balance: A two-armed randomized controlled trial in healthy older adults. Int J Environ Res Public Health. 2019; 16: E3721. [CrossRef]
  51. Yang K, Bernardo LM, Sereika SM, Conroy MB, Balk J, Burke LE. Utilization of 3-month yoga program for adults at high risk for type 2 diabetes: A pilot study. Evid Based Complement Alternat Med. 2011; 2011: 257891. [CrossRef]
  52. Innes KE, Selfe TK. The effects of a gentle yoga program on sleep, mood, and blood pressure in older women with restless legs syndrome (RLS): A preliminary randomized controlled trial. J Evid Based Complement Alternat Med. 2012; 2012: 294058 [CrossRef]
  53. McCaffrey R, Taylor D, Marker C, Park J. A pilot study of the effects of chair yoga and chair-based exercise on biopsychosocial outcomes in older adults with lower extremity osteoarthritis. Holist Nurs Pract. 2019; 33: 321-326. [CrossRef]
  54. Wooten SV, Signorile JF, Desai SS, Paine AK, Mooney K. Yoga meditation (YoMed) and its effect on proprioception and balance function in elders who have fallen: A randomized control study. Complement Ther Med. 2018; 36: 129-136. [CrossRef]
  55. Grahn Kronhed AC, Enthoven P, Spångeus A, Willerton C. Mindfulness and modified medical yoga as intervention in older women with osteoporotic vertebral fracture. J Altern Complement Med. 2020; 26: 610-619. [CrossRef]
  56. Chan W, Immink MA, Hillier S. Yoga and exercise for symptoms of depression and anxiety in people with poststroke disability: A randomized, controlled pilot trial. Altern Ther Health Med. 2012; 18: 34-43.
  57. Barrows JL. Yoga for HEART (health empowerment and realizing transformation) intervention to enhance motivation for physical activity in older adults. Arizona State University ProQuest Dissertations Publishing; 2018.
  58. Halpern J, Cohen M, Kennedy G, Reece J, Cahan C, Baharav A. Yoga for improving sleep quality and quality of life for older adults. Altern Ther Health Med. 2014; 20: 37-46.
  59. Kertapati Y, Sahar J, Nursasi AY. The effects of chair yoga with spiritual intervention on the functional status of older adults. Enfermería Clínica. 2018; 28: 70-73. [CrossRef]
  60. Fan JT, Chen KM. Using silver yoga exercises to promote physical and mental health of elders with dementia in long-term care facilities. Int Psychogeriatr. 2011; 23: 1222-1230. [CrossRef]
  61. Furtado GE, Uba Chupel M, Carvalho HM, Souza NR, Ferreira JP, Teixeira AM. Effects of a chair-yoga exercises on stress hormone levels, daily life activities, falls and physical fitness in institutionalized older adults. Complement Ther Clin Pract. 2016; 24: 123-129. [CrossRef]
  62. Yao CT, Tseng CH. Effectiveness of chair yoga for improving the functional fitness and well-being of female community-dwelling older adults with low physical activities. Top Geriatr Rehabil. 2019; 35: 248-254. [CrossRef]
  63. Auguste EJ, Weiskittle RE, Sohl SJ, Danhauer SC, Doherty K, Naik AD, et al. Enhancing access to yoga for older male veterans after cancer: Examining beliefs about yoga. Fed Pract. 2021; 38: 450-458. [CrossRef]
  64. Park J, McCaffrey R, Newman D, Cheung C, Hagen D. The effect of Sit “N” Fit chair yoga among community-dwelling older adults with osteoarthritis. Holist Nurs Pract. 2014; 28: 247-257. [CrossRef]
  65. Park J, McCaffrey R, Dunn D, Goodman R. Managing osteoarthritis: Comparisons of chair yoga, Reiki, and education (pilot study). Holist Nurs Pract. 2011; 25: 316-326. [CrossRef]
  66. Buchanan DT, Vitiello MV, Bennett K. Feasibility and efficacy of a shared yoga intervention for sleep disturbance in older adults with osteoarthritis. J Gerontol Nurs. 2017: 1-10. [CrossRef]
  67. Sohl SJ, Danhauer SC, Birdee GS, Nicklas BJ, Yacoub G, Aklilu M, et al. A brief yoga intervention implemented during chemotherapy: A randomized controlled pilot study. Complement Ther Med. 2016; 25: 139-142. [CrossRef]
  68. McCaffrey R, Park J, Newman D, Hagen D. The effect of chair yoga in older adults with moderate and severe Alzheimer’s disease. Res Gerontol Nurs. 2014; 7: 171-177. [CrossRef]
  69. Hall SF, Wiering BA, Erickson LO, Hanson LR. Feasibility trial of a 10-week adaptive yoga intervention developed for patients with chronic pain. Pain Manag Nurs. 2019; 20: 316-322. [CrossRef]
  70. Ben Josef AM, Wileyto EP, Chen J, Vapiwala N. Yoga intervention for patients with prostate cancer undergoing external beam radiation therapy: A pilot feasibility study. Integr Cancer Ther. 2016; 15: 272-278. [CrossRef]
  71. Widjaja W, Jitvimolnimit K, Ajjimaporn A, Laskin JJ. Effect of modified thai yoga on energy cost and metabolic intensity in obese older adult thai women. Adv Rehabil. 2019; 33: 47-54. [CrossRef]
  72. Wang MY, Greendale GA, Kazadi L, Salem GJ. Yoga improves upper extremity function and scapular posturing in persons with hyperkyphosis. J Yoga Phys Ther. 2012; 2: 117. [CrossRef]
  73. Galantino ML, Green L, DeCesari JA, MacKain NA, Rinaldi SM, Stevens ME, et al. Safety and feasibility of modified chair-yoga on functional outcome among elderly at risk for falls. Int J Yoga. 2012; 5: 146-150. [CrossRef]
  74. Boehnke KF, LaMore C, Hart P, Zick SM. Feasibility study of a modified yoga program for chronic pain among elderly adults in assisted and independent living. Explore. 2022; 18: 104-107. [CrossRef]
  75. Wang MY, Greendale GA, Yu SSY, Salem GJ. Physical-performance outcomes and biomechanical correlates from the 32-week yoga empowers seniors study. Evid Based Complement Alternat Med. 2016; 2016: 6921689. [CrossRef]
  76. Smith PD, Mross P, Christopher N. Development of a falls reduction yoga program for older adults-A pilot study. Complement Ther Med. 2017; 31: 118-126. [CrossRef]
  77. Litchke LG, Hodges JS, Reardon RF. Benefits of chair yoga for persons with mild to severe Alzheimer’s disease. Act Adapt Aging. 2012; 36: 317-328. [CrossRef]
  78. Zettergren KK, Lubeski JM, Viverito JM. Effects of a yoga program on postural control, mobility, and gait speed in community-living older adults: A pilot study. J Geriatr Phys Ther. 2011; 34: 88-94. [CrossRef]
  79. Schmid AA, Van Puymbroeck M, Koceja DM. Effect of a 12-week yoga intervention on fear of falling and balance in older adults: A pilot study. Arch Phys Med Rehabil. 2010; 91: 576-583. [CrossRef]
  80. Cohen ET, Kietrys D, Fogerite SG, Silva M, Logan K, Barone DA, et al. Feasibility and impact of an 8-week integrative yoga program in people with moderate multiple sclerosis–related disability. Int J MS Care. 2017; 19: 30-39. [CrossRef]
  81. King K, Gosian J, Doherty K, Chapman J, Walsh C, Azar JP, et al. Implementing yoga therapy adapted for older veterans who are cancer survivors. Int J Yoga Therap. 2014; 24: 87-96. [CrossRef]
  82. Schmid AA, Van Puymbroeck M, Portz JD, Atler KE, Fruhauf CA. Merging yoga and occupational therapy (MY-OT): A feasibility and pilot study. Complement Ther Med. 2016; 28: 44-49. [CrossRef]
  83. Bower JE, Garet D, Sternlieb B. Yoga for persistent fatigue in breast cancer survivors: Results of a pilot study. Evid Based Complement Alternat Med. 2011; 2011: 623168. [CrossRef]
  84. Vizcaino M. The effect of yoga practice on glucose control, physiological stress, and well-being in type 2 diabetes: Exploring a mechanism of action. ProQuest Dissertations and Theses. Texas: The University of Texas at El Paso; 2017.
  85. Miller Therapeutic-yoga after stroke: Effect on walking recovery. 2013. Indiana University IUPUI SchoarWorksRepository. doi: 10.7912/C2/1385.
  86. Fouladbakhsh JM, Davis JE, Yarandi HN. A pilot study of the feasibility and outcomes of yoga for lung cancer survivors. Oncol Nurs Forum. 2014; 41: 162-174. [CrossRef]
  87. Boulgarides LK, Barakatt E, Coleman Salgado B. Measuring the effect of an eight-week adaptive yoga program on the physical and psychological status of individuals with Parkinson’s disease. A pilot study. Int J Yoga Therap. 2014; 24: 31-41. [CrossRef]
  88. Park J, Tolea M, Rosenfeld A, Arcay V, Karson J, Lopes Y, et al. Feasibility and effects of chair yoga to manage dementia symptoms in older adults. Innov Aging. 2018; 2: 312. [CrossRef]
  89. Curtis KJ, Hitzig SL, Leong N, Wicks CE, Ditor DS, Katz J. Evaluation of a modified yoga program for persons with spinal cord injury. Ther Recreat J. 2015; 49: 97.
  90. Alexander GK, Innes KE, Selfe TK, Brown CJ. “More than I expected”: Perceived benefits of yoga practice among older adults at risk for cardiovascular disease. Complement Ther Med. 2013; 21: 14-28. [CrossRef]
  91. Schulz Heik RJ, Meyer H, Mahoney L, Stanton MV, Cho RH, Moore Downing DP, et al. Results from a clinical yoga program for veterans: Yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga. BMC Complement Altern Med. 2017; 17: 198. [CrossRef]
  92. Litchke LG, Hodges JS. The meaning of “Now” moments of engagement in yoga for persons with Alzheimer’s disease. Ther Recreat J. 2014; 48: 229-246.
  93. Papp ME, Henriques M, Biguet G, Wändell PE, Nygren Bonnier M. Experiences of hatha yogic exercises among patients with obstructive pulmonary diseases: A qualitative study. J Bodyw Mov Ther. 2018; 22: 896-903. [CrossRef]
  94. Saravanakumar P, Higgins IJ, Van Der Riet PJ, Sibbritt D. Tai chi and yoga in residential aged care: Perspectives of participants: A qualitative study. J Clin Nurs. 2018; 27: 4390-4399. [CrossRef]
  95. Schaff TR. Senior yoga: In and out of chairs. Top Geriatr Rehabil. 2012; 28: 223-237. [CrossRef]
  96. Park J, Tolea MI, Sherman D, Rosenfeld A, Arcay V, Lopes Y, et al. Feasibility of conducting nonpharmacological interventions to manage dementia symptoms in community-dwelling older adults: A cluster randomized controlled trial. Am J Alzheimers Dis Other Demen. 2020; 35:1533317519872635. [CrossRef]
  97. Bukowski EL, Conway A, Glentz LA, Kurland K, Galantino ML. The effect of Iyengar yoga and strengthening exercises for people living with osteoarthritis of the knee: A case series. Int Q Community Health Educ. 2007; 26: 287-305. [CrossRef]
  98. Awdish R, Small B, Cajigas H. Development of a modified yoga program for pulmonary hypertension: A case series. Altern Ther Health Med. 2015; 21: 48-52.
  99. Wang F, Szabo A. Effects of yoga on stress among healthy adults: A systematic review. Altern Ther Health Med. 2020; 26: AT6214.
  100. Cramer H, Lauche R, Langhorst J, Dobos G. Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials. Complement Ther Med. 2016 Apr; 25:178-87. doi: 10.1016/j.ctim.2016.02.015. Epub 2016 Mar 3. PMID: 27062966. [CrossRef]
  101. Sivaramakrishnan D, Fitzsimons C, Kelly P, Ludwig K, Mutrie N, Saunders DH, et al. The effects of yoga compared to active and inactive controls on physical function and health related quality of life in older adults- systematic review and meta-analysis of randomised controlled trials. Int J Behav Nutr Phys Act. 2019; 16: 33. [CrossRef]
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