YOGA EXERCISE INTERVENTION IMPROVES BALANCE CONTROL AND 
PREVENTS FALLS IN SENIORS AGED 65+
Milada KREJČÍ1*, Martin HILL2, Jiří KAJZAR1, Miroslav TICHÝ1, Vaclav HOŠEK1
1College of Physical Education and Sport Palestra, Wellness and Nutrition Science, 
Slovačíkova 400/1, 19700 Prague, Czech Republic 
2Institute of Endocrinology, 19700 Prague, Czech Republic 
Received: Jul 14, 2021
Accepted: Jan 20, 2022
Original scientific article
*Corresponding author: Tel. + 420 606 512 076; E-mail: krejci@palestra.cz
10.2478/sjph-2022-0012 Zdr Varst. 2022;61(2):85-92
85
UKREP Z VAJAMI JOGE IZBOLJŠA NADZOR RAVNOTEŽJA 
IN PREPREČUJE PADCE PRI STAREJŠIH OD 65 LET
© National Institute of Public Health, Slovenia. 
Krejčí M, Hill M, Kajzar J, Tichý M, Hošek V. Yoga exercise intervention improves balance control and prevents falls in seniors aged 65+. 
Zdr Varst. 2022;61(2):85-92.  doi: 10.2478/sjph-2022-0012.
ABSTRACT
Keywords: 
ageing, balance 
control, chair yoga, 
health promotion, 
social health
IZVLEČEK
Ključne besede: 
staranje, nadzor 
ravnotežja, joga 
na stolu, promocija 
zdravja, socialno 
zdravje
Introduction: Body balance control represents a key factor preventing falls and subsequent injuries in seniors 
aged 65+. Intervention based on yoga exercises seem to be effective in improving balance. 
Objective: The objective is to analyse and compare changes in static, dynamic, and total balance scores, 
changes in body composition and social indices as effects of yoga-based intervention.
Methods: A total of 500 participants (234 men aged 74.5 SD±7.74 and 266 women aged 76.9 SD±7.23) were 
assessed using the Tinetti Balance Assessment Tool, the InBody 230 bioimpedance body composition analyser, 
and the SF-36 Health Survey, applied to pre and post-testing. The experimental group (n=262; 122 males; 140 
females) underwent a four-week yoga-based intervention, 30 minutes daily, while the control group (n=238; 
112 males; 126 females) underwent its usual daily programme at senior homes or centres. The ANOVA model, 
consisting of the Group, Stage, Subject and Group × Stage interaction factors, was used for data evaluation. 
Results: Intervention led to improvements in the static, dynamic and total balance scores in the experimental 
group compared to the control group. The results of SF-36 showed positive changes in the psychosocial aspects 
of health, such as promoting of calmness and happiness in male seniors and reducing fatigue, nervousness and 
depression in female seniors. The post-intervention decrease in body fat percentage and increase in muscle 
mass in seniors is discussed. 
Conclusions: The four-week yoga-based intervention had positive effects on the static, dynamic and total 
balance scores, body composition and social status.  
Uvod: Nadzor telesnega ravnotežja je ključni dejavnik za preprečevanje padcev in posledičnih poškodb pri 
starejših od 65 let. Videti je, da ukrep na osnovi vaj joge učinkovito pripomore k izboljšanju ravnotežja. 
Cilj: Cilj je analizirati in primerjati spremembe ocene statičnega, dinamičnega in skupnega ravnotežja, 
spremembe sestave telesa ter spremembe socialnih kazalnikov po izvedbi ukrepa na osnovi vaj joge.
Metode: 500 udeležencev (234 moških povprečne starosti 74,5 leta, SD ± 7,74 leta, in 266 žensk povprečne 
starosti 76,9 leta, SD ± 7,23 leta) je bilo v predhodnem in naknadnem testiranju ocenjenih z orodjem Tinetti 
za oceno ravnotežja (Tinetti Balance Assessment Tool), analizatorjem bioelektrične impedance InBody 230 
in vprašalnikom o zdravju SF-36. Pri eksperimentalni skupini (n = 262; 122 moških; 140 žensk) je bil izveden 
4-tedenski ukrep na osnovi vaj joge, ki so se izvajale 30 minut na dan, medtem ko je kontrolna skupina (n = 
238; 112 moških; 126 žensk) izvajala svoj običajen dnevni program v domovih ali centrih za starejše. Za oceno 
podatkov je bil uporabljen model ANOVA s faktorji Skupina, Stopnja in Subjekt ter interakcijo Skupina × Stopnja. 
Rezultati: Ukrep je v eksperimentalni skupini privedel do izboljšanja ocene statičnega, dinamičnega in skupnega 
ravnotežja v primerjavi s kontrolno skupino. Rezultati vprašalnika SF-36 so pokazali pozitivne spremembe na 
področju psihosocialnih vidikov zdravja, kot sta povečanje mirnosti in sreče pri starejših moških ter zmanjšanje 
utrujenosti, živčnosti in depresivnosti pri starejših ženskah. Opisano je zmanjšanje odstotka telesne maščobe 
in povečanje mišične mase pri starejših po izvedbi ukrepa. 
Zaključki: 4-tedensko izvajanje ukrepa na osnovi vaj joge je pozitivno vplivalo na oceno statičnega, dinamičnega 
in skupnega ravnotežja, sestavo telesa in socialni status.  
1 INTRODUCTION
The European Union defines the term ‘senior’ as a person 
aged 65 years and above with rights to a pension, social 
security and healthcare (1, 2). Seniors aged 65+ are at 
higher risk of falling, which can be potentially devastating 
for maintaining independence (3, 4). Fear of falling and 
the consequent loss of independence are a common 
challenge among seniors (5). Longer life expectancy will 
result in a greater proportion of seniors suffering from 
locomotor impairment. More comprehensive rehabilitation 
and training practice is therefore necessary (6). From 
this point of view, chair-based yoga interventions could 
be an effective rehabilitation strategy among the elderly 
(7). Balance development exercises have been shown 
to reduce the risk of falls. Effective and safe exercises 
may reverse frailty in the elderly, can increase strength 
and power, improve balance and reduce fall incidence. 
From this perspective, exercise interventions should 
become a daily routine among the elderly (8). A lack of 
movement, i.e. ‘hypokinetic syndrome’, manifests itself in 
impulsiveness, irritability, a reduced ability to concentrate, 
and increased anxiety and depression (8, 9).  A common 
problem among the elderly is fear and anxiety about 
the deterioration of balance control and the consequent 
loss of independence (10). Whereas the limbic system is 
involved in conscious activity, the amygdala is involved 
in the emotional evaluation of input information and 
emotion-driven behaviour, including social interaction. 
The information that passes from the parabrachial 
pathway to the amygdala brings information about pain, 
including information from the skin and internal organs, 
with the accompaniment of emotions associated with 
pain, anxiety, phobia, etc. (11). The efferent pathways 
from the amygdala go mainly to the hypothalamus, which 
is the site of stress transfers to the autonomic, immune, 
endocrine and humoral management systems. The ageing 
of the hypacus, eye defects and other sensory disorders 
lead to somatic imbalances and therefore emotional 
imbalances, with all the negative effects these have on 
social interaction. Balance intervention, which involves 
the leaching of endorphins and enkephalins, has a positive 
effect on amygdala function and, secondarily, a positive 
impact not only on somatic balance but also on emotional 
and social balance (12, 13). A combination of function-
oriented challenges with balance control that stimulates 
the sensory and neuromuscular control mechanism, as 
well as muscle strength, body flexibility and joint mobility, 
may be realised among the elderly through the application 
of a short-term yoga-based intervention (14, 15). The 
results of a four-week yoga-based intervention indicated 
that participants’ body fat percentage and systolic blood 
pressure decreased, and that balance and the range of 
motion of shoulder flexion and abduction improved. It is 
important to note that other similar exercise intervention 
10.2478/sjph-2022-0012 Zdr Varst. 2022;61(2):85-92
86
studies for the elderly showed that the positive effects on 
balance development and body composition (16, 17) lasted 
only four weeks. The objective is to analyse and compare 
changes in static, dynamic and total balance scores, 
changes in body composition and social indices as effects 
of yoga-based intervention.  Based on the objective of the 
study, the hypothesis is that ‘applied four-week intensive 
intervention based on yoga exercises leads to a significant 
improvement in the total balance score among seniors in 
the experimental group’.
2 METHODS AND PROCEDURE
2.1 Participants and data collection
A study involved 500 seniors aged 65+ (234 men with an 
average age of 74.5 SD±7.74; 266 women with an average 
age of 76.9 SD±7.23), selected by stratified randomised 
sampling from all the regions of the Czech Republic. The 
participants were grouped into the experimental group 
(n=162; 122 males, age average 72.8, SD±7.44, median 
71 (67.0, 78.0); 140 females, age average 76.1, SD±8.03, 
median 76.0 (69.0, 81.0) and the control group (n=112 
males, age average 72.2, SD±6.54, median 71.0 (67.0, 
74.0); 126 females, age average 72.9, SD±7.32, median 
70.5 (67.0, 76.0). During randomising, similar numbers of 
participants for both samples were retained in the homes 
or centres at which the participants were based.
All the participants signed up for the research voluntarily, 
which they confirmed by signing a consent form in 
the medical record. Before they signed the form, all 
participants were given information on the method, 
measurements and exercise itself. However, participants 
were not informed of the purpose of the research. The 
research institution’s ethics committee expressed its full 
agreement and indicated that the research conformed with 
the requirements stipulated in the Declaration of Helsinki. 
The exclusion criteria for the involvement of participants 
in the experimental study were determined according to 
the White Book on Physical and Rehabilitation Medicine 
in Europe (18) and were as follows: (i) human-to-human 
infectious diseases and bacillus carriers, (ii) all acute-stage 
diseases and conditions in which destabilisation of health 
status can be reasonably expected, (iii) cachexia of various 
aetiologies, (iv) malignant tumours, (v) active attacks or 
phases of psychoses and mental disorders with asocial 
manifestations or with reduced communication, (vi) 2nd and 
3rd degree of urinary incontinence and stool incontinence.
The pre/post examination started with the medical 
anamnesis provided by a physician, followed by a 
bioimpedance assessment of body composition provided 
by an anthropologist. Subsequently, a balance exam using 
the Tinetti Balance Assessment Tool was provided. Each 
participant then completed an SF-36 survey with the 
assistance of a researcher. The survey was used according 
to its official manual (19).
10.2478/sjph-2022-0012 Zdr Varst. 2022;61(2):85-92
87
2.2 Methods
2.2.1 Medical anamnesis
The medical anamnesis protocol was performed by a 
physician (20) using a standardised protocol specifically 
focused on the current health status of seniors and on 
drugs, injuries and surgeries. Finally, the physician made 
a medical recommendation as to whether to include an 
individual in the study. 
2.2.2 Pre/post examination
2.2.2.1 Assessment of body composition
Body height was measured using the Tanita Leicester 
Height Measure device (Invicta Plastics, Leicester, United 
Kingdom) with an accuracy of 0.1 cm. The InBody 230 
tetrapolar multi-frequency bioelectrical impedance 
device (InBody, Seoul, South Korea) was used to assess 
body weight, BMI, body fat percentage and total muscle 
mass (21), performed at the same time and under the same 
conditions, in underwear, barefoot, standing upright.
2.2.2.2 Balance assessment
The Tinetti Balance Assessment Tool was used to measure 
the static, dynamic and total balance score (18). The static 
balance test is assessed on the basis of the observation 
of an individual’s somatic behaviour during sitting and 
standing positions and the changes to that behaviour, 
which are defined by nine items. Dynamic balance is 
judged by eight items that involve characteristics of gait 
manifested in an individual during a walk across a 4.5 m 
walkway, first at their usual pace, then at a rapid pace. 
The maximum total scores are 16 and 12 points for static 
balance and dynamic balance (gait), respectively. The 
higher the score, the better the performance. The Tinetti 
Balance Assessment Tool reported good to excellent 
intra- and inter-rater reliability, an intraclass correlation 
coefficient > .80, and medium sensitivity and specificity 
to identify fallers (22, 23).
2.2.2.3 RAND 36 Short Form Health Survey (SF-36) 
SF-36 represents a valid and reliable indicator of overall 
health status and is used globally. It comprises 36 items, 
including social health and general health perceptions. 
The survey has a reliability of r=.65 to .94 across the 
scales, with a median of .85, resulting in very good 
internal consistency and item-discriminant validity (24).
2.2.3 Intervention
The experimental group’s four-week intervention was 
focused on body posture, balance control, flexibility, 
muscle strength, breathing and relaxation. The exercises 
were carried out using the Yoga in Daily Life System 
(25), without contraindications to the elderly (Sarvahita 
Asanas), while sitting on a chair or standing by a chair. 
They included: pulling arms up, turning the shoulders, leg 
stretch, hamstring stretch, shoulder stretch, finger stretch, 
toe stretch, bottom lift, knee bends, forward bend, 
balance exercises standing behind a chair with support, 
standing on one leg, diaphragm breathing, modified ‘cat 
pose’ breathing, ‘lion grimace’ breathing, exercises to 
relax the muscles of the face and neck, and vibration 
exercises with vibrational effects in the diaphragm, lung 
and brain areas. Once per week, a main training lesson 
lasting 90 minutes was conducted with 10–12 participants 
under the guidance of a coach and two assistants. After 
this training, each participant received an educational 
sheet for the specific week. They featured the following 
mottos: Week 1 ‘You are never alone’, Week 2 ‘Change is 
always possible’, Week 3 ‘Movement is life’, Week 4 ‘Enjoy 
life and every moment’ (26). During the week, participants 
repeated the learned exercises daily for 30 minutes under 
the supervision of the assistants. The participants were 
present and supervised at the care centre on a daily basis. 
During the intervention, the control group had their usual 
daily regime at the same care centres.
2.3 Data analysis 
ANOVA model consisting of the factor Subject (explaining 
inter-individual variability), the between-subject factor 
Group (experimental vs. control groups), and the within-
subject factor Stage (before intervention vs. after 
intervention). Before the ANOVA processing, the original 
data was transformed by means of a power transformation 
to attain symmetrical distribution and constant variance 
(homoscedasticity) in data and residuals (27). Data 
distribution symmetry and data homogeneity were 
checked as described elsewhere (28). The statistical 
software Statgraphics Centurion 18 from Statgraphics 
Technologies, Inc. (The Plains, Maryland, USA) was used 
for the calculations.
3 RESULTS
A good randomised experiment is an essential tool for 
testing the efficacy of any intervention. We therefore 
tried to generate comparable intervention groups that 
would be alike in all important aspects (except for the 
intervention). The basic values of the subjects assigned 
to the control and experimental groups are presented 
according to sex, i.e. basic values of monitored men 
(Table 1) and monitored women (Table 2). The values 
presented displayed a high level of accordance before the 
intervention in the monitored groups.
3.1 Balance changes
In both, i.e. among the monitored males and females, the 
intervention effect on balance was found to be significant 
for the performance of the static and dynamic balance 
test, p<.001. The Group × Measurement interaction 
(p<.001) showed significant improvements of static and 
dynamic balance in the experimental group compared to 
the control group of monitored male and female seniors. 
A significant positive effect of the intervention was also 
indicated by the Group × Measurement interaction for the 
total balance score (p<.001), see Tables 3 and 4. 
3.2 Body composition changes
On the basis of statistical analyses of body composition, 
the data verified that both, i.e. male and female seniors 
in the experimental group, had more muscle mass after 
the intervention compared to males and female seniors 
in the control group. The intervention led to a significant 
improvement in two body composition measurements. 
In the experimental group, the body fat percentage 
decreased among the monitored seniors (males by 1.7%, 
females by 1.9%) while in the control group, the median 
of this variable increased (males by 0.3%, females by 
0.15%). The analysis showed that the measurement had a 
significant effect on body fat percentage, p<.001, with a 
large effect size.
In seniors in the experimental group, total muscle mass 
increased (males by median 1.3 kg, females by median 
1.03 kg) after the intervention, while seniors in the control 
group remained at the same mean values (Tables 3 and 4). 
3.3 Intervention effects on psychosocial health 
indicators 
The post-intervention results of the social indicators 
among monitored male seniors showed that the 
intervention had significant positive effects on self-help 
abilities (Table 3). The yoga-based intervention led to 
positive changes in performance and in concentration on 
work and other activities, and in emotional balance, i.e. 
feelings of calmness and happiness (Table 3). By contrast, 
there were no psychosocial changes among male seniors 
in the control group. 
From the statistical analyses of the SF-36 survey, the 
females in the experimental group displayed higher post-
intervention emotional and social progress. Compared to 
females in the control group, they enjoyed a reduction 
in fatigue, nervousness, sadness, and depression (see 
Table 4), thereby increasing their potential for social 
interaction. Progress in physical fitness, such as ‘climbing 
one staircase’, also indicates a significant improvement 
in independence and possible social interactions among 
female seniors in the experimental group (Table 4).
Age (years)
Height (cm)
Weight (kg)
Body fat (%)
Muscle mass (kg)
Static balance score
Dynamic balance (gait score)
Total balance score
Age (years)
Height (cm)
Weight (kg)
Body fat (%)
Muscle mass (kg)
Static balance score
Dynamic balance (gait score)
Total balance score
Control group
KS
p-value*
p-valuew
Experimental group
ES
Variable
ID
71 (67.1, 74.3) 
174 (170, 178) 
82 (73.8, 94.3) 
26 (22, 35) 
34 (29, 39) 
14.5 (11, 16) 
10 (9, 12) 
25 (21, 27) 
70 (67, 76) 
164 (160, 168) 
73 (64, 81.2) 
33.5 (30, 42) 
30 (25.3, 32.1) 
14 (11, 16) 
10.5 (9, 12) 
24 (21, 27.8) 
0.186
0.790
0.575
0.838
0.388
0.394
0.195
0.280
0.034
0.409
0.487
0.959
0.528
0.872
0.800
0.823
73 (68, 80) 
174 (170, 180) 
85 (77.8, 90) 
26 (22, 33.3) 
35 (30, 40) 
14 (10.8, 15) 
10 (8, 12) 
24 (18, 27) 
73 (68, 80) 
163 (158, 166) 
71.4 (62.5, 83) 
35 (27, 45.2) 
30 (24, 32) 
15 (10, 16) 
11 (8, 12) 
25 (18, 28) 
Table 1.
Table 2.
Basal values (shown as median with quartiles) of monitored groups of male seniors (N=234; Experimental group: 122 males; 
Control group:  112 males).
Basal values (shown as median with quartiles) of monitored groups of female seniors (N=266; Experimental group: 140 
females; Control group: 126 females).
*Mann-Whitney test
88
10.2478/sjph-2022-0012 Zdr Varst. 2022;61(2):85-92
Static balance score
Dynamic balance  
(gait score)
Total balance score
Body fat (%)
Muscle mass (kg)
Q12 Self-help ability
Q18 Accomplished 
less than would like
Q19 Less careful in  
work or other activities
Q26 Feelings  
of calmness
Q30 To be happy
-
+
-
+ 
-
+
-
+
-
+
-
+
-
+ 
-
+ 
-
+ 
-
+
13.8 (13.7, 13.9) 
13.2 (13.2, 13.3) 
10.4 (10.3, 10.5) 
9.9 (9.83, 9.96)  
24.1 (24, 24.3) 
23.1 (23, 23.2) 
26.6 (26.3, 26.9) 
26.9 (26.7, 27.2) 
33.9 (33.8, 34.1) 
34.8 (34.7, 34.9) 
2.96 (2.95, 2.98) 
2.88 (2.87, 2.89) 
1.85 (1.83, 1.87) 
1.75 (1.73, 1.77)  
1.85 (1.83, 1.87) 
1.72 (1.7, 1.73)  
2.94 (2.85, 3.04) 
2.49 (2.42, 2.56)  
3.08 (2.98, 3.18) 
2.53 (2.45, 2.6) 
13.9 (13.8, 14) 
13.8 (13.7, 13.8) 
10.3 (10.3, 10.4) 
10.2 (10.2, 10.3) 
 
24.2 (24.1, 24.3) 
23.9 (23.8, 24) 
26.9 (26.6, 27.2) 
25.2 (25, 25.5) 
33.9 (33.7, 34) 
36.1 (36, 36.2) 
2.93 (2.92, 2.94) 
2.89 (2.88, 2.9) 
1.82 (1.8, 1.85) 
1.79 (1.77, 1.81)  
1.85 (1.83, 1.87) 
1.78 (1.76, 1.8)  
2.64 (2.55, 2.73) 
2.47 (2.4, 2.54)  
2.83 (2.73, 2.92) 
2.6 (2.52, 2.67) 
30.2
32 
 
61
 
14.3
 
243.8
 
61.8
 
20 
 
54.5 
 
27.5
  
38
<0.001
<0.001 
 
<0.001
 
<0.001
 
<0.001
 
<0.001
 
<0.001 
 
<0.001 
 
<0.001
  
<0.001
0.17
0.173 
 
0.29
 
0.113
 
0.683
 
0.288
 
0.115 
 
0.263 
 
0.153
  
0.199
29.7
6.9 
 
24.5
 
14.9
 
40.9
 
3.6
 
0.2
 
 
4.7
  
7.3
 
 
2.1
<0.001
0.01 
 
<0.001
 
<0.001
 
<0.001
 
0.061
 
0.624
  
0.032 
 
0.008
 
 
0.151
 
0.167
0.043 
 
0.141
 
0.117
 
0.266
 
0.023
 
<0.01
  
0.03 
 
0.046
  
0.013
11.1
13.3 
 
18.1
 
30.5
 
48.7
 
7.3
 
4.8
  
4.7 
 
5.8
  
6.6
0.001
<0.001 
 
<0.001
 
<0.001
 
<0.001
 
0.008
 
0.03
  
0.032 
 
0.018
  
0.012
0.07
0.08 
 
0.108
 
0.214
 
0.301
 
0.046
 
0.03
  
0.03
 
 
0.036
  
0.041
46.1
34.2 
 
66.2
 
60.3
 
155.6
 
19
 
14.5
  
19.7
  
11.9
 
 
11.7
 
<0.001
<0.001 
 
<0.001
 
<0.001
 
<0.001
 
<0.001
 
<0.001
  
<0.001
  
<0.001
  
<0.001
 
0.979
0.972 
 
0.985
 
0.984
 
0.994
 
0.95
 
0.936
 
 
0.952
  
0.923
  
0.922
 
Variable
Stage Group Pre-Post Group × Stage Subj(Group)
ANOVA, factors and interaction
Pre Post F F F Fp p p pη
p
2 ηp
2 ηp
2 ηp
2
Ex
pe
ri
m
en
t
Table 3. Significant differences in pre-post changes (significant Group × Stage interaction) in the Tinetti balance test scores, 
body composition and social indicators after the balance-exercise intervention when a comparison is made between the 
experimental and control groups of monitored male seniors (N=234; experimental group: 122 males; control group:  112 males).
F, p, and ηp
2 represent F-statistics, p-values, and effect sizes, respectively. For the effect size: 0.01 ~ small effect, 0.06 ~ medium effect, 
>0.14 ~ large effect.
*Retransformed mean with 95% confidence intervals
Static balance score
Dynamic balance 
(gait score)
Total balance score
Body fat (%)
Muscle mass (kg)
-
+
-
+ 
-
+
-
+
-
+
13.5 (13.4, 13.5) 
13.6 (13.5, 13.6) 
10.4 (10.3, 10.4) 
10.3 (10.2, 10.3)  
23.8 (23.7, 23.9) 
23.8 (23.7, 23.8) 
35 (34.8, 35.3) 
35.1 (34.9, 35.3) 
29.2 (29.1, 29.3) 
29 (28.9, 29) 
13.6 (13.5, 13.6) 
13.7 (13.7, 13.8) 
10.4 (10.4, 10.5) 
10.5 (10.5, 10.5) 
 
24 (23.9, 24.1) 
24.3 (24.3, 24.4) 
34.9 (34.6, 35.1) 
33.2 (33.1, 33.4) 
29.5 (29.4, 29.6) 
30 (29.9, 30.1) 
16.9
<0.1 
 
4.6
 
29.5
 
2.2
 
<0.001
0.906 
 
0.032
 
<0.001
 
0.142
 
0.063
<0.01 
 
0.017
 
0.121
 
0.01
 
23.3
11.5 
 
35.5
 
47.2
 
102.6
 
<0.001
<0.001 
 
<0.001
 
<0.001
 
<0.001
 
0.084
0.041 
 
0.116
 
0.18
 
0.328
 
0.7
4.9 
 
9.7
 
34.3
 
32.4
 
0.404
0.027 
 
0.002
 
<0.001
 
<0.001
 
<0.01
0.018 
 
0.035
 
0.138
 
0.134
 
161.5
38.4 
 
84
 
95.8
 
106
 
<0.001
<0.001 
 
<0.001
 
<0.001
 
<0.001
 
0.994
0.975 
 
0.988
 
0.99
 
0.991
 
Variable
Stage Group Pre-Post Group × Stage Subj(Group)
ANOVA, factors and interaction
Pre Post F F F Fp p p pη
p
2 ηp
2 ηp
2 ηp
2
Ex
pe
ri
m
en
t
Table 4. Significant differences in pre-post changes (significant Group × Pre-Post interaction) in the Tinetti balance test scores, body 
composition and social indicators after the balance-exercise intervention when a comparison is made between the experimental 
and control groups of monitored female seniors (N=266; experimental group: 140 females; control group: 126 females).
89
10.2478/sjph-2022-0012 Zdr Varst. 2022;61(2):85-92
Q3 Vigorous activities
Q7 Climbing one 
flight of stairs
Q24 To be nervous
Q25 Depressive feelings
Q31 To feel tired
-
+
-
+ 
-
+
-
+
-
+
1.76 (1.74, 1.78) 
1.71 (1.69, 1.73) 
2.57 (2.54, 2.59) 
2.4 (2.38, 2.42)  
4.44 (4.37, 4.52) 
4.36 (4.31, 4.42) 
5.32 (5.26, 5.38) 
5.15 (5.1, 5.19) 
3.66 (3.6, 3.72) 
3.76 (3.72, 3.81) 
1.73 (1.71, 1.75) 
1.74 (1.73, 1.76) 
2.55 (2.52, 2.57) 
2.47 (2.45, 2.49) 
 
4.33 (4.25, 4.4) 
4.47 (4.42, 4.52) 
5.25 (5.19, 5.31) 
5.24 (5.19, 5.28) 
3.55 (3.49, 3.62) 
3.82 (3.78, 3.87) 
2.9
 
57.3 
 
0.5
 
6.2
 
22.9
0.089
 
<0.001 
 
0.489
 
0.013
 
<0.001
0.011
 
0.175 
 
<0.01
 
0.022
 
0.078
 
<0.1
 
1.9 
 
<0.1
 
0.1
 
0.3
0.94
 
0.173 
 
0.907
 
0.819
 
0.596
<0.01
 
<0.01 
 
<0.01
 
<0.01
 
<0.01
5.2
 
6.7 
 
5.7
 
4.5
 
4.3
0.023
 
0.01 
 
0.018
 
0.034
 
0.039
0.019
 
0.024 
 
0.021
 
0.017
 
0.016
15.2
 
30.3 
 
9.8
 
11.9
 
13.5
<0.001
 
<0.001 
 
<0.001
 
<0.001
 
<0.001
 
0.938
 
0.968 
 
0.907
 
0.923
 
0.931
Variable
Stage Group Pre-Post Group × Stage Subj(Group)
ANOVA, factors and interaction
Pre Post F F F Fp p p pη
p
2 ηp
2 ηp
2 ηp
2
Ex
pe
ri
m
en
t
F, p, and ηp
2 represent F-statistics, p-values, and effect sizes, respectively. For the effect size: 0.01 ~ small effect, 0.06 ~ medium effect, 
>0.14 ~ large effect.
*Retransformed mean with 95% confidence intervals
4 DISCUSSION
Postural control is essential for active daily activities and 
is an integral part of elderly independence and mobility. 
The personal, social and economic burden of health 
complications caused by falls and balance problems among 
seniors is still an issue globally, as highlighted by authors 
(29, 30) in the USA, EU and Canada within the context of 
chronic diseases and disabilities. As our findings show, the 
Tinetti Balance Assessment Tool may be used to evaluate 
the risk of falls as well as the measures and interventions 
taken to prevent falls and to develop gait in the elderly. 
This is consistent with the statement that gait ability prior 
to fracture had a significant impact on an elderly person’s 
ability to survive after suffering a hip fracture (31).
It is therefore possible to recommend regular yoga-based 
exercises for seniors aged 65+, as it helps to reduce the 
number of fall-related cases. The results of the present 
study demonstrate that yoga-based interventions can 
have significant positive effects, and can therefore be 
recommended to seniors aged 65+ to help them develop 
postural control in a relatively short time. In this study, 
a short-term yoga-based intervention also led to an 
improvement in the dynamic balance of monitored seniors 
aged 65+, and can therefore help optimise walking. These 
results are consistent with the results of other studies 
that have highlighted the positive effects of yoga-based 
intervention and that make similar recommendations for 
improving balance confidence and stability among older 
people after a six-week multimodal balance-enhancing 
exercise programme (32, 33). 
It seems plausible that regular yoga training can support 
anabolic processes in the elderly. This statement is 
consistent with the results of the studies (34, 35). 
Accordingly, it can be argued that men aged 65+ can 
respond positively to exercise intervention, including 
reductions in body fat and increases in muscle mass, 
because of testosterone. However, we should also address 
the increase in muscle mass and fat loss in women 
aged 65+. The authors (36, 37) state that routine yoga 
exercises affect the use of protein throughout the body in 
healthy older women. After yoga-based intervention, the 
participants had lower body fat and higher muscle mass 
than those who did not practise yoga; moreover, they 
also tended to have better balance. Practising yoga can 
improve protein utilisation and lead to the maintenance 
of muscle mass in females later in life, when muscle loss 
is common.
The study looks at the social effects within the context of 
positive changes in balance control and body composition. 
The results are consistent with the results of studies (38, 
39) that highlight the psychosocial health benefits of yoga-
based interventions. The present study is unique in that it 
examines the effects after a four-week intervention. 
There were also positive increases in subjective feelings of 
happiness, vitality, energy and social balance. The results 
may inspire future research applications in the field of 
kinanthropology, healthcare and social care. Applied yoga 
techniques, which promote total balance performance in 
seniors aged 65+ in a simple and effective way, may be 
the subject of further research, with a particular focus on 
intersexual interactions with balance improvement.
90
10.2478/sjph-2022-0012 Zdr Varst. 2022;61(2):85-92
4.1 Limitations of the study
The findings should be interpreted with caution. Further 
validation of the research is required. Although the results 
are promising and the number of subjects was relatively 
high, they may not be representative of the general senior 
public at the age under observation. Another limitation 
of the present study was the potential influence of the 
actual state of anxiety on the performance of static and 
dynamic balance. However, it should be emphasised that 
measurements using the Tinetti tool are adequate for the 
seniors monitored.
5 CONCLUSIONS
The significant positive improvements in static and 
dynamic balance, with significant body integration, 
including decreases in fat and increases in muscle mass, 
point to the importance of simple yoga exercises, which 
could constitute a safe physical activity for the over 65s.
Chair-yoga based intervention represents a financially 
and spatially undemanding, physically well manageable, 
feasible, well-tolerated, and safe intervention, and one 
that may help seniors to develop the balance condition 
necessary for mobility and social interactions. Using yoga-
based intervention to increase social balance is a highly 
relevant topic for the over 65s.
The findings of the study are new, and provide a basis for 
future research interventions to promote active ageing.
CONFLICT OF INTEREST
The authors declare that no conflicts of interest exist.
FUNDING 
The study was funded by the Czech Science Foundation as 
part of the project GAČR ID 17-25710S ‘Basic research of 
balance changes in seniors’. 
ETHICAL APPROVAL 
The study was approved by the Ethics Committee of 
the College of Physical Education and Sport PALESTRA, 
Prague, Czech Republic.
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