Dementia is characterized not only by cognitive decline, but also by deteriorating physical function. This major cause of limitation in daily activities in older adults with dementia necessitates non-pharmacological approaches that are safe, effective, and evidence-based. Chair yoga is one such approach. Chair yoga is a noninvasive and low-impact intervention that combines flexibility, balance, strength, breathing, relaxation, and mindfulness training while sitting or standing on a chair.
Unfortunately, transportation issues, living in rural areas, relying on caregivers, and, most notably, the COVID-19 pandemic have prevented many older adults with dementia from participating in group-based in-person chair yoga classes. These burdens necessitate an innovative approach to delivering a chair yoga intervention to those who are unable to travel to a community center.
"The significant time and cost associated with traveling to in-person yoga sessions over several weeks could be burdensome to many patients," said Juyoung Park, Ph.D., senior author, principal investigator, and professor in Florida Atlantic University's College of Social Work and Criminal Justice's Phyllis and Harvey Sandler School of Social Work.
Researchers from FAU's College of Social Work and Criminal Justice, Christine E. Lynn College of Nursing, and Schmidt College of Medicine, along with collaborators, conducted a novel interdisciplinary study to evaluate a remotely supervised online chair yoga intervention targeted at older adults with dementia, and clinical outcomes were measured virtually via Zoom under remote supervision. The study investigated the relationship between chair yoga and clinical outcomes such as pain interference, mobility, risk of falling, sleep disturbance, autonomic reactivity, and loneliness.
According to the study's findings, which were published in the journal Complementary Therapies in Clinical Practice, remotely supervised online chair yoga is a feasible approach for managing physical and psychological symptoms in socially isolated older adults with dementia, based on retention (70%) and adherence (87.5%), with no injury or other adverse events.
"This finding is significant because older adults with dementia and their caregivers may face difficulties in attending chair yoga programs at community facilities," said Park, who conducted the study with her mentee and co-author Hannah Levine, a medical student at FAU. "Because it was easily accessible from home and did not require transportation or childcare, our telehealth-based chair yoga intervention was found to be convenient for both participants and their caregivers."
For eight weeks, participants in the pilot study attended twice weekly 60-minute sessions. The yoga interventionist was highlighted in the Zoom screen during the chair yoga session, allowing participants to see only the interventionist. Participants were able to focus on the yoga sessions because they were not distracted by other participants on the screen.
"Our study participants practiced breathing techniques and intentional practice; physical postures; and guided relaxation and visualization with a certified yoga interventionist and their caregivers," Park explained.
Participants also interacted on Zoom with other participants or with the facilitator in order to maintain social bonds while physically separated. At baseline, mid-intervention, and post-intervention, psychosocial and physiological (i.e., cardiac) data were collected remotely.