Yoga and bone health research
Little research has been done to study how
yoga may play a role in supporting bone health. In 2015 Dr. Loren Fishman had a
study published in Topics in Geriatric Rehabilitation (1). The results of his
study suggest that a twelve-minute daily yoga regimen may help to reverse
osteoporosis. The purpose of his research was to assess the effectiveness of
selected yoga postures in raising bone mineral density.
Dr. Fishman recruited 741 volunteers through
the internet between 2005 and 2015. The volunteers had to submit a DEXA scan of
their spines and hips at the beginning of the study, as well as laboratory
tests. Those who qualified for the study had to follow instructions on how to
do the set of yoga poses regularly and they were asked to document what they did
on logs.
Out of the 741 volunteers, 227
participants completed the yoga routine. The average age of the participants
was 68 when they entered the study. Eighty-three percent (83%) of the
participants had lower-than-normal bone density. The DEXA scans done at the end
of the study showed that bone mineral density improved in spine, hips and
femur. Monthly gains in BMD (bone mineral density) was significant in spine (p:0.005)
and femur (p: 0.053). For the hip the gain was not considered statistically
significant. No fractures or serious injuries were reported as a result of the
practice of yoga.
The results are promising and more research is
needed to support these findings. However, the improvement of bone mineral
density is not the only feature we consider important to evaluate the impact of
yoga on the health of bones. Cognition, balance and muscle strength play a
vital role to prevent falls and fractures.
Studies have shown that yoga may
improve balance in seniors (2 and 3). A small study published by Experimental
Gerontology in 2020 showed that the practice of yoga twice a week for two weeks
improved the balance of the participants. Cognitive changes were not detected,
but the study was done for only ten weeks and the number of participants was
too small. Other studies have also shown that balance improves with the regular
practice of yoga. Yoga is cost-effective and safe when it is done under the
guidance of qualified teachers or therapists with a clear understanding of
medical conditions that require modified poses to meet the needs of the
practitioner.
A study published by Mayo Clinic in 2019
highlighted the need to offer a safe yoga practice as it found that people with
osteopenia and osteoporosis have a higher risk of being injured during the
practice of yoga (4). The study emphasized the need to modify the practice to
make it safe. Based on their research, Melody Lee and colleagues concluded that
patients with osteopenia and osteoporosis may have a higher risk of compression
fractures or deformities and would benefit from avoiding extreme spinal
flexion. The researchers also pointed out that patients with degenerative disk
disease or facet arthropathy experienced exacerbation of their symptoms after
certain yoga poses, particularly extremes of flexion and extension (4). Proper
yoga instruction should acknowledge these risks and offer props and
modifications.
The Mayo Clinic research cautions us
to avoid deep twists such as revolved triangle (Parivritta Trikonasana) in
people with underlying back issues. All in all, extremes in the range of motion
need to be avoided in these cases, and this means avoiding the full version of
a pose and choosing a modified version of it.
A model of safety with appropriate
modifications is well described in Dr. Gail Greendale's Yoga Empowers Seniors
Study (YESS). Precise descriptions of the asanas (postures) are provided to
adapt the poses to common physical ailments (5).
To continue the research of the
effects of yoga and meditation along with the development of clear safety
guidelines for patients, it will be necessary to design studies with
standardized ways of measuring both objective and subjective indicators of
balance, the maintenance and stability of healthy physical posture over time
and the reduction of fall risk (6). We hope the scientific community will
commit to this purpose considering that yoga and meditation are cost-effective
practices whose emerging research has shown multiple health benefits for people
of all ages (7).
It is important to remember that yoga
is not the only body-mind practice that can provide multiple benefits in terms
of balance and prevention of falls. Tai Chi Chuan, for example, has been shown
to be effective at preventing falls, improving balance, proprioception, muscle
strength and endurance (8).
References:
1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851231/
2) https://pubmed.ncbi.nlm.nih.gov/23825035/
3) https://www.sciencedirect.com/science/article/abs/pii/S0531556520303466?via%3Dihub
4) https://www.mayoclinicproceedings.org/article/S0025-6196(18)30940-6/fulltext
5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639444/
6) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3995122/
8) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323335/
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