Email updates

Keep up to date with the latest news and content from BMC Complementary and Alternative Medicine and BioMed Central.

Open Access Research article

Adherence to yoga and exercise interventions in a 6-month clinical trial

KE Flegal1, S Kishiyama1, D Zajdel1, M Haas3 and BS Oken12*

Author Affiliations

1 Department of Neurology, Oregon Health & Science University, Portland, USA

2 Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA

3 Center for Outcome Studies, Western States Chiropractic College, Portland, USA

For all author emails, please log on.

BMC Complementary and Alternative Medicine 2007, 7:37  doi:10.1186/1472-6882-7-37

Published: 9 November 2007

Abstract

Background

To determine factors that predict adherence to a mind-body intervention in a randomized trial.

Design

We analyzed adherence data from a 3-arm trial involving 135 generally healthy seniors 65–85 years of age randomized to a 6-month intervention consisting of: an Iyengar yoga class with home practice, an exercise class with home practice, or a wait-list control group. Outcome measures included cognitive function, mood, fatigue, anxiety, health-related quality of life, and physical measures. Adherence to the intervention was obtained by class attendance and biweekly home practice logs.

Results

The drop-out rate was 13%. Among the completers of the two active interventions, average yoga class attendance was 77% and home practice occurred 64% of all days. Average exercise class attendance was 69% and home exercise occurred 54% of all days. There were no clear effects of adherence on the significant study outcomes (quality of life and physical measures). Class attendance was significantly correlated with baseline measures of depression, fatigue, and physical components of health-related quality of life. Significant differences in baseline measures were also found between study completers and drop-outs in the active interventions. Adherence was not related to age, gender, or education level.

Conclusion

Healthy seniors have good attendance at classes with a physically active intervention. Home practice takes place over half of the time. Decreased adherence to a potentially beneficial intervention has the potential to decrease the effect of the intervention in a clinical trial because subjects who might sustain the greatest benefit will receive a lower dose of the intervention and subjects with higher adherence rates may be functioning closer to maximum ability before the intervention. Strategies to maximize adherence among subjects at greater risk for low adherence will be important for future trials, especially complementary treatments requiring greater effort than simple pill-taking.