Hamrick 2017.
| Methods | Study design: RCT Number of study arms: 2 Length of follow‐up: 6 months | |
| Participants | Setting: Wisconsin, USA Number of participants: 43 Number analysed: 38 Number lost to follow‐up: 5 Sample: community‐dwelling Age (years): mean 69.9 (range 60 ‐ 88) Sex: 79% female Inclusion: 60 years and older; able to walk 150 feet without assistive devices; cognitively intact as evidenced by correct answers to the Memory Impairment Screen; able to provide informed consent Exclusion criteria: pelvic or lower extremity injury in the previous 6 months that required temporary use of an assistive device, including crutches, for > 7 days; inability to provide informed consent; neurologic condition that impairs strength or balance including herniated lumbar disc with nerve root compression, previous stroke with residual lower extremity weakness, Parkinson’s Disease, multiple sclerosis, muscular dystrophy and other neuromuscular diseases; cardiac or other medical condition with previous physician instructions to avoid low‐intensity exercise; terminal condition with rapid progression of disease and not expected to live > 6 months; pelvic or lower extremity orthopaedic surgery in the previous 12 months.; practised yoga at home or in a classroom setting in the past 6 months |
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| Interventions | 1. Home‐exercise group: instructed to practice 3 yoga home poses for 10 minutes + 5 minutes of relaxation (breathing techniques) daily for 8 weeks 2. Relaxation group: instructed to practice 5 minutes of relaxation daily for 8 weeks Both groups attended 60‐minute yoga classes, 2 a week for 8 weeks |
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| Outcomes | 1. Rate of falls 2. Number of people who experienced 1 or more falls (risk of falling) |
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| Duration of the study | 26 weeks | |
| Adherence | Attendance in the 16 yoga sessions was 92% | |
| Notes | Source of funding: Wisconsin Partnership Program Economic information: not reported Email communication to obtain fall data, response received, data included in review |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Quote: "Participants were randomly assigned 1:1 by concealed allocation at enrollment". Method of randomisation not stated |
| Allocation concealment (selection bias) | Unclear risk | Quote: "Participants were randomly assigned 1:1 by concealed allocation at enrollment". Method of concealment is not described |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Participants and yoga instructors were not blinded to group allocation, but the impact of non‐blinding is unclear |
| Blinding of outcome assessment (detection bias) Falls | Low risk | Quote: "participants underwent assessment at baseline and within 1 week of completing the classes by one of the authors who was blinded to participant home exercise assignment. We conducted a telephone survey about falls ... 2 months and 4 months after completing the class" |
| Blinding of outcome assessment (detection bias) Fractures | Unclear risk | Not applicable |
| Blinding of outcome assessment (detection bias) Hospital admission, medical attention and adverse events | Unclear risk | Not applicable |
| Blinding of outcome assessment (detection bias) Health related quality of life (self report) | Unclear risk | Not applicable |
| Incomplete outcome data (attrition bias) Falls and fallers | Low risk | Less than 20% of fall outcome data are missing (11%). Loss of fall data was balanced in the treatment groups |
| Selective reporting (reporting bias) | Unclear risk | Minimum set of expected outcomes not reported (adverse events not reported) |
| Method of ascertaining falls (recall bias) | High risk | Logs were given to inspire tracking of falls but logs were not collected. Telephone survey about falls 2 months and 4 months after completion of the intervention |