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/

7)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5332914/#:~:text=Medical%20Yoga%20Therapy%20or%20%E2%80%9CYoga,the%20underlying%20causes%20of%20disease

8) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323335/

 

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