This study looked at three interventions with older adults with dementia symptoms. Chair yoga was compared to a music intervention and chair based exercise.  Participants, mostly with moderate to severe dementia, were able to safely participate and adhered to the intervention with low attrition rate.  The yoga group improved significantly in quality of life compared to the music intervention, the yoga and exercise  group both showed lower depression scores. In creating this intervention an important emphasis was given to adapting philosophical principles and yamas/niyamas for the population.  Broad themes foundational to yoga philosophy such as compassion, equanimity, joy, wonder or awe were selected.  These themes were paired with particular yamas and niyamas such as ahimsa (kindness or nonharming); asteyna (nonstealing); satya (truth); aparigrapha (nongrasping); tapas (will, vitality, confidence); isvara pranidhana (faith, surrender).  These themes were integrated throughout the practice through meditations, reflections, particular statements that the yoga teacher/therapist would focus on,  and short mantras set to the breath (inhalation and exhalation) that the participants could repeat.

For example:

• Compassion was linked with ahimsa (kindness or non-harming) which was linked to ideas of self-love, “I am filled with love and peace”, and inhale love, exhale love.
• Gratitude was linked to asteya (non-stealing) which was connected to ideas such as “I am filled with gratitude for myself and others”; inhale gratitude for myself, exhale gratitude for others; and inhale say thank you to yourself, exhale and say thank you to a loved one.
• Joy/wonder/awe were linked to isvara pranidhana (surrender or faith). This was connected to the idea of finding joy in all that arises; “Inhale I connect to joy, exhale wonder and awe for all that surrounds me” and “ imagine a sunrise, sunset, your favorite place- Inhale beauty of that place, exhale the beauty of that place

The chair yoga program included cues for body awareness throughout the movement, adaptations of postures were used so that some people were sitting throughout the class and others used the wall and chairs to stand.  

This study was supported by Florida Atlantic University, Division of Research, Institute for Healthy Living and Lifespan Studies and led by Dr. JuYoung Park. The paper was published in the American Journal of  Alzheimer’s Disease and other Dementias.

Publication of the Study
https://journals.sagepub.com/doi/abs/10.1177/1533317519872635

Park, J., Tolea, M. I., Sherman, D., Rosenfeld, A., Arcay, V., Lopes, Y., & Galvin, J. E. (2019). Feasibility of Conducting Nonpharmacological Interventions to Manage Dementia Symptoms in Community-Dwelling Older Adults: A Cluster Randomized Controlled Trial. American Journal of Alzheimer’s Disease & Other Dementias®, 1533317519872635.

Other articles on the study
http://www.fau.edu/newsdesk/articles/chair-yoga-dementia.php

https://psychcentral.com/news/2019/10/11/chair-yoga-may-improve-quality-of-life-in-dementia-patients/150737.html

This pilot study showed that it was safe and feasible to conduct both chair yoga and chair exercise interventions in a low-income senior housing facility.  Physical function improved in both groups including balance and strength and mobility with no adverse events and good adherence/low attrition rate. The classes were led at the facility so that there was no travel required and also provided a group experience and  social interaction within a known environment. 

The chair yoga program included adaptations for postures, pranayama, meditation, and relaxation

This study was supported by Mercer University and led by Dr. Ruth McCaffrey, Dr. David Taylor, and Dr. Juyoung Park.

McCaffrey, R., Taylor, D., Marker, C., & Park, J. (2019). A Pilot Study of the Effects of Chair Yoga and Chair-Based Exercise on Biopsychosocial Outcomes in Older Adults With Lower Extremity Osteoarthritis. Holistic nursing practice, 33(6), 321-326.

This study looked at an individualized yoga program at a military medical center on pain disability, physical function, symptoms burden. The yoga group reported significantly improved pain as well as a tendency towards positive change in the other outcomes compared to the control group.

The sessions were provided 1:1 with an assessment to enable the yoga teacher/therapist to adapt the practices depending on both physical and psychological factors to meet the clients present-moment needs. Each session include postures, pranayama, meditation, relaxation. The yoga program focused on postures to target common musculoskeletal and movement imbalances present in low back pain along with cues for increasing body awareness and  healthy interoceptivity and modifications to change the intensity or intention as appropriate to the individual.  Each posture included directions for specific intentions such as correct muscular activations or releases to focus on. Common misalignments and their contributors were detailed so that the teacher/therapist could modify the postures appropriately and optimally to the needs of the individual.  Cues were also provided to promote greater inquiry, inner attention, and a meditative focus to the movement practice.  This included cues to facilitate stability in areas of the body such as the pelvis, low back, and hips; using the breath to cultivate a present-moment focus, to bring attention to tension in the body and to certain areas; to notice when the breath became altered and tension arose and how to change this; and to notice the relationship between movement, body sensation and thoughts/emotions.

This study was supported by the  U.S.. Department of the Army, Telemedicine and Advanced Technology Research Center, U.S. Army Medical and Materiel Command, and Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. under Cooperative Agreement (W81XWH-11-2-0201).Clinical Trial Registration No.: NCT02132910.

The published work can be found here: Benefits of the Restorative Exercise and Strength Training for Operational Resilience and Excellence Yoga Program for Chronic Low Back Pain in Service Members: A Pilot Randomized Controlled Trial.

Publication of the Study
https://www.sciencedirect.com/science/article/abs/pii/S0003999317310821