Effect of yoga on balance, falls, and bone metabolism: a systematic review of randomized controlled trials in healthy individuals.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39607489 · doi:10.1007/s00198-024-07307-x
What was done
This systematic review and meta-analysis evaluated 18 randomized controlled trials with 1,408 healthy participants investigating the effect of yoga on balance, falls, fear of falling, bone mineral density (BMD), and bone turnover markers (BTMs). Interventions included various yoga styles (Hatha, Vinyasa, Ashtanga, Iyengar, Bikram, and tailored protocols) lasting from 6 weeks to 14 months compared to no-intervention controls (NIC) or active comparators such as Tai Chi. Risk of bias was evaluated with Cochrane RoB 2, and evidence certainty was graded using GRADE.
What was found
Fifteen RCTs assessed balance, falls, or fear of falling, and three assessed BMD and BTMs. A meta-analysis of four RCTs comparing yoga to NIC showed significant improvement in static balance with yoga (SMD = 2.36; 95% CI 1.13 to 3.58; P = 0.0002; I² = 93%). Effects on falls and fear of falling were mixed. Two studies reported positive effects on bone formation markers, while only one showed improved BMD; a meta-analysis of two RCTs found no significant effect of yoga on BMD compared to NIC.
Why it matters
Yoga can be an effective intervention for improving balance in healthy individuals, though evidence does not currently support its efficacy for improving bone mineral density or consistently reducing falls.
Limits
The certainty of evidence for balance improvements is low, marked by high statistical heterogeneity (I² = 93%), wide variation in yoga styles and durations, and 24 different balance assessment tools across trials. Very few trials (three) evaluated bone outcomes, limiting conclusions on skeletal health.