A groundbreaking study conducted by researchers at the University of Sydney has delivered unexpected and thought-provoking findings regarding the safety and efficacy of Iyengar yoga for older adults. Published in The Lancet Healthy Longevity, the investigation revealed that this widely practiced yoga style may actually increase the incidence of falls among individuals aged 60 and above by an alarming 33 percent. This revelation challenges long-standing beliefs around the role of exercise—and yoga in particular—in fall prevention and invites a critical reassessment of how we approach balance training for aging populations.
The randomized controlled trial enrolled 700 participants aged 60 and over who had no prior experience practicing yoga. These individuals were randomly assigned into two groups: one engaged in a 12-month Iyengar yoga-based exercise program delivered online under instructor guidance, while the control group participated in a self-guided seated relaxation yoga intervention. Throughout the year-long study, researchers meticulously tracked the frequency of falls reported monthly by each participant. Contrary to the initial hypothesis that yoga’s balance-promoting postures would reduce fall risk, the data charted a statistically significant increase in falls among those engaging in Iyengar yoga exercises.
Professor Anne Tiedemann, the senior author leading this investigation and a Healthy Ageing expert at the Institute for Musculoskeletal Health, expressed both surprise and reflection upon the counterintuitive results. She noted there was extensive evidence supporting general exercise as an effective fall prevention strategy for older adults. However, the singular nature of yoga—especially the fixed postural holds emphasized in the Iyengar tradition—seemed not to translate into reduced falls. Instead, it suggested that improvements in balance from this yoga form may lack the specificity and functional applicability required for preventing real-world falls.
Delving deeper into the profiles of participants who exhibited increased fall risk, the study unearthed that those with no previous history of falling, individuals who maintained a higher level of physical activity, and participants who self-rated their balance as good or excellent were paradoxically more vulnerable following the yoga intervention. This raises complex questions about how confidence gained through yoga might inadvertently encourage older adults to engage in riskier behaviors or activities outside structured exercise sessions, thereby amplifying fall risk rather than mitigating it.
Further speculation surrounds the online delivery modality necessitated by the COVID-19 pandemic, which potentially curtailed the intensity and fidelity of instruction. According to Dr. Juliana Oliveira, the study’s first author, the safety precautions inherent in remote sessions likely tempered the introduction of more challenging poses, hindering progress in balance skill mastery. Participants also reported difficulties in pushing themselves to achieve optimal postural control without direct, in-person supervision, which may have impacted functional gains and safety during practice.
Interestingly, despite the increased incidence of falls, the Iyengar yoga program manifested beneficial effects on various dimensions of health and well-being. Participants displayed greater success in reaching personal exercise goals, exhibited enhanced confidence in stair climbing, and improved their functional strength—especially in movements such as rising from the floor. This duality highlights that while this form of yoga may not be well-suited as a stand-alone intervention for fall prevention, it nonetheless offers substantial health benefits that contribute to overall quality of life.
The findings underscore the multifaceted nature of fall risk among older adults, governed by the interplay of individual physiology, exercise specificity, environmental contexts, and behavioral factors. Conventional wisdom around balance training is challenged by recognizing that improvements in static postures do not necessarily equate with safer mobility during dynamic, everyday activities. The study emphasizes that exercise programs must be carefully designed to ensure task-specificity, functional relevance, and contextual adaptability when aiming to reduce falls.
Crucially, the research team advocates that older adults interested in yoga, particularly Iyengar yoga, consult healthcare providers to tailor exercise routines that optimize safety. Alternative balance-focused exercises such as squats, lunges, and heel raises remain evidenced-based options currently recommended for fall risk amelioration. This calls for a balanced, evidence-informed approach to integrating complementary practices like yoga into comprehensive fall prevention strategies.
The study’s implications reverberate throughout public health and geriatric care domains, challenging assumptions about the presumed benign nature of yoga practice in older populations. It invites the scientific community to probe deeper into how different exercise modalities interact with aging neuro-musculoskeletal systems and behavioral tendencies, as well as to examine the impact of delivery modality—whether online or in-person—on adherence, intensity, and outcomes.
While the pandemic-imposed shift to online program delivery complicated the intended protocol, it also opens avenues for future research to compare remote versus face-to-face interventions. The balance between accessibility and quality of instruction remains a critical consideration as digital health platforms become ever more prolific in reaching older adults who may face barriers to attending in-person classes.
In summary, this robust randomized controlled trial overturns some prevailing expectations, revealing that Iyengar yoga as delivered remotely may inadvertently elevate fall risk among older Australians. Nonetheless, it spotlights the nuanced landscape of exercise science in aging populations and reminds clinicians, researchers, and practitioners that the efficacy of physical activity interventions hinges not merely on general activity levels but on precise alignment with functional goals and risk profiles.
This study stands as a landmark contribution, urging an informed reevaluation of yoga’s role within fall prevention frameworks and encouraging multidimensional approaches that harmonize safety, functional benefit, and personal empowerment for older adults seeking to maintain mobility and independence.
Subject of Research: People aged 60 years and older.
Article Title: The effect of an Iyengar yoga-based exercise programme versus a seated yoga relaxation programme on falls in people aged 60 years and older (SAGE): a pragmatic, two-arm, parallel randomised controlled trial.
News Publication Date: 23-Sep-2025.
Web References: https://www.thelancet.com/journals/lanhl/home, DOI: 10.1016/j.lanhl.2025.100749
References: Oliveira J.S., Sherrington C., Lord S.L., Camara G.C., Colley S., West C., Haynes A., Gilchrist H., Kwok W.S., Pearce L.M.N., Wallbank G., Trent M., Bauman A., Grunseit A.C., Anstey K.J., Tiedemann A., ‘The effect of an Iyengar yoga-based exercise programme versus a seated yoga relaxation programme on falls in people aged 60 years and older (SAGE): a pragmatic, two-arm, parallel randomised controlled trial’ (Lancet Healthy Longevity, 2025).
Keywords: Yoga, Fall prevention, Older adults, Iyengar yoga, Balance training, Physical activity, Gerontology, Exercise intervention, Randomized controlled trial, Health outcomes, COVID-19 impact, Online exercise delivery.
