Effects of Different Mind-body Exercises in Managing Chronic Pain of Older Adults: A Network Meta-analysis of Randomized Trials.

INTRODUCTION: Mind-body exercises (MBEs) were shown to be effective in managing chronic pain among older adults in several recent studies. However, the differences in the effects of different MBEs remained unclear. OBJECTIVE: To compare the effects of different MBEs in managing chronic pain in older adults. METHODS: Eight databases were searched for studies published between 2012 and 2023, and 14 studies were included in this systematic review and network meta-analysis (NMA). The NMA was performed using R and Metainsight. RESULTS: Results showed that tai chi and yoga were effective in alleviating chronic pain, but their effects were not superior to traditional physical exercises and other MBEs. In addition, none of the MBEs were shown to be effective in mitigating chronic pain-related disabilities. CONCLUSION: Tai chi and yoga can be used for relieving chronic pain in older adults; however, MBE programs alone were not sufficient to mitigate chronic pain-related disabilities.

The effect of music interventions on chronic pain experienced by older adults: A systematic review.

PURPOSE: To synthesize results from multiple studies to determine the effects of music interventions on chronic pain in older adults. DESIGN: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline to identify and select studies. METHODS: Relevant studies were identified from nine electronic databases. The Joanna Briggs Institute (JBI) critical appraisal checklists were employed to assess methodological quality. All authors performed screening, data extraction, and synthesis. Inclusion criteria were clinical trials investigating music for chronic pain in older adults aged 65 and older. FINDINGS: Eight studies involving 524 older adults were included, comprising five randomized controlled trials and three quasi-experimental studies. Music interventions consisted of live music, recorded music, and active music, with a variety of music styles and genres. Despite the small and short-term effects, five studies presented significantly positive outcomes for reducing chronic pain and its common comorbidities in older adults following music interventions. Three studies reported decreased trends in pain scores although they did not reach statistical significance. CONCLUSIONS: Music has potential to be an effective adjuvant for managing chronic pain in older adults. CLINICAL RELEVANCE: Nurses can incorporate music into the care of older adults with chronic pain.

Acupunch Exercise Program Development and Feasibility Evaluation for Older Adults.

PURPOSE: The aim of the study was to develop the Healthy Beat Acupunch (HBA) exercise program and evaluate its feasibility for community older adults. DESIGN: Stage I: The Delphi technique was used to consult 16 experts to develop the program. Stage II: A preexperimental, one-group, posttest-only design was used to pilot-test the program feasibility with 31 older adults. METHODS: After 4 weeks of interventions, participants evaluated the program based on four criteria (simplicity, safety, suitability, and helpfulness) and responded to five open-ended questions. FINDINGS: The developed HBA program from Stage I includes three phases with 24 motions and takes 40 minutes to complete. Program feasibility in Stage II showed average scores ranged from 8.84 ± 1.32 to 9.97 ± 0.18. CONCLUSION: Both experts and elderly participants confirmed that the HBA program was simple, safe, suitable, and helpful to older adults. CLINICAL RELEVANCE: The HBA program provides older adults with a new set of exercise options.

Meridian Cuffing Exercises Improved Functional Fitness and Cardiopulmonary Functioning of Community Older Adults.

This study was aimed to test the effects of a meridian cuffing exercise, the Healthy Beat Acupunch (HBA) regimen, on the functional fitness and cardiopulmonary functioning of community older adults. A single-blind, cluster randomized controlled trial was conducted. We randomly allocated eight community care centers to the intervention or control group and recruited 228 participants who completed the study (intervention: four centers, n = 111; control: four centers, n = 117). The intervention group underwent a 40-min session of HBA regimen 3 times per week for 6 months. Functional fitness and cardiopulmonary functioning were assessed at baseline, 3 months, and 6 months of the intervention. The intervention group demonstrated significantly greater improvements in functional fitness and cardiopulmonary functioning than the control group between baseline and either 3 months or 6 months. We suggest that activities designed to promote health among community older adults include acupunch exercises.

Systematic Review and Meta-Analysis on Using Acupressure to Promote the Health of Older Adults.

Acupressure is noninvasive, safe, and appropriate for use among older adults. However, there remains little evidence of the common elements that contribute to the effectiveness of acupressure in promoting the health of older adults. A systematic review using meta-analysis was designed to examine the effects of acupressure on the health promotion in older adults. Studies published between 2012 and 2017 were searched for in 11 electronic databases. Acupressure was highly effective for improving sleep quality and cognitive functioning (0.85, 95% confidence interval [CI] = [0.49, 1.22]; 1.23, 95% CI = [0.88, 1.59]). A slight to moderate effect was found in alleviating constipation (0.37, 95% CI = [0.03, 0.71]), and a moderate effect was found for alleviating pain and improving quality of life (0.71, 95% CI = [0.09, 1.32]; 0.59 95% CI = [0.36, 0.82]).

Self-evaluation by community older adults on the applicability of the healthy beat acupunch exercise program.

Objectives To evaluate the applicability of the Healthy Beat Acupunch (HBA) exercise program for older adults at community care centers and to explore their perceived impacts and suggestions for program protocol after six months of HBA exercises. Design & setting This prospective and descriptive study recruited 113 older adults from four community care centers. Intervention The HBA exercises were conducted 3 times a week, 40 min per session, for six months. Main outcome measures The program evaluation focused on four criteria: simplicity, safety, suitability, and helpfulness of the three phases of the HBA program using a 10-point ladder scale. The semi-structured interviews were focused on the participants' exercise experiences, perceived impacts on their health, and suggestions for the HBA program protocol. Results The average scores of the four criteria in each phase of the program ranged between 9.59 and 9.98 points. Participants reported an increase in their limb flexibility (n = 31) and that they were more relaxed (n = 26) and more energetic (n = 26) after engaging in the HBA exercises. Most of the participants suggested that the HBA program should be offered three times a week, 40 min per session, with 30 people in a group, and led by instructors who were professional, hardworking, easygoing, and enthusiastic, regardless of gender and age. Conclusions The HBA program was rated at a high level of simplicity, safety, suitability, and helpfulness by community older adults, which indicated that the program was considered as appropriate and applicable for the older population.

Effects of horticulture therapy on nursing home older adults in southern Taiwan.

PURPOSE: This study aimed to test the effects of horticulture therapy on activities of daily living, happiness, meaning of life, and interpersonal intimacy of nursing home older adults in southern Taiwan. METHODS: A quasi-experimental study was applied. Eighty-five older adults aged 65 or older who lived in nursing homes in southern Taiwan were recruited conveniently. All participants completed the study: experimental group (n = 41) and control group (n = 44). The experimental group received horticulture therapy for 1 h once a week for 8 weeks, while the control group continued their routine daily activities. The following questionnaires were administered before and after the intervention period: (1) Barthel Index (BI), (2) Chinese Happiness Inventory short version (CHI), (3) Meaning of Life Scale (MLS), and (4) Interpersonal Intimacy Scale (IIS). RESULTS: The BI, CHI, MLS, and IIS scores significantly improved in the experimental group (p < .05). After 8 weeks of horticulture therapy, the BI, CHI, and IIS scores of experimental group participants were significantly better than the scores of control group participants (p < .05); however, the MLS scores of two groups showed no significant differences (p = .738). CONCLUSIONS: Horticulture therapy improved activities of daily living, happiness, and interpersonal intimacy of older adults in nursing homes. We recommend that nursing homes recruit and train personnel to lead horticultural therapy and to incorporate the therapy as routine daily activities in the facilities.

Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial.

CLINICAL TRIALS IDENTIFIER: NCT02329873. BACKGROUND: Acute exacerbation (AE) of COPD is characterized by a sudden worsening of COPD symptoms. Previous studies have explored the effectiveness of respiratory rehabilitation for patients with COPD; however, no training program specific to acute exacerbation in elderly patients or unstable periods during hospitalization has been developed. OBJECTIVE: To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD. METHODS: A randomized control trial was conducted. Pretest and posttest evaluations of 61 elderly inpatients with AECOPD (experimental group n=30; control group n=31) were performed. The experimental group received respiratory rehabilitation exercise training twice a day, 10-30 minutes per session for 4 days. The clinical parameters (dyspnea, cough, exercise tolerance, and sputum expectoration) were assessed at the baseline and at the end of the fourth day. RESULTS: All participants (median age =70 years, male =60.70%, and peak expiratory flow 140 L) completed the study. In the patients of the experimental group, dyspnea and cough decreased and exercise tolerance and sputum expectoration increased significantly compared with those of the patients in the control group (all P<0.05). Within-group comparisons revealed that the dyspnea, cough, and exercise tolerance significantly improved in the experimental group by the end of the fourth day (all P<0.05). CONCLUSION: Results of this study suggest that the respiratory rehabilitation exercise training package reduced symptoms and enhanced the effectiveness of the care of elderly inpatients with AECOPD.

The effect of music therapy on cognitive functioning among older adults: a systematic review and meta-analysis.

OBJECTIVES: To conduct a systematic review and a meta-analysis of current studies to determine whether music therapy affects the cognitive function of older people. DESIGN: The databases surveyed include PsycINFO, PsycARTICLES, PubMed, MEDLINE, CINAHL, AgeLine, Cochrane Library, and the Chinese Electronic Periodical Services (CEPS) as well as the reference lists of the included studies. The Consolidated Standards of Reporting Trials (CONSORT) extension checklist for nonpharmacologic treatment was used to evaluate the literature. SETTING: Music therapy intervention offered in nursing homes, hospitals, or communities. PARTICIPANTS: A total of 234 participants from 5 studies were assessed in the meta-analysis, with a mean age per study of 71.4 to 82.0 years. MEASUREMENTS: Cognitive outcome domains were analyzed in a systematic review. The short-term effects of music therapy in Mini-Mental State Examination data for meta-analysis were compiled. A forest plot was constructed using a fixed effect model to obtain a pooled mean difference. RESULTS: Active music therapy comprising singing and other musical activities was generally determined to effect a significant improvement in the Mini-Mental State Examination according to individual retrieval studies. However, this study showed no significant improvement in the short-term effects of music therapy when all related studies in meta-analysis were combined. The pooled mean difference was 0.73 (95% confidence interval -0.07 to 1.54; Z = 1.79; P = .07) for using music therapy overall and 0.74 (95% confidence interval -0.08 to 1.56; Z = 1.76; P = .08) for using active music therapy. CONCLUSIONS: The findings of the meta-analysis indicate that the short-term effects of music therapy do not improve the cognitive function of older people. Future studies that utilize a good quality methodology with a long-term design and diversified active music therapy are recommended.

Development and feasibility of a senior elastic band exercise program for aged adults: a descriptive evaluation survey.

OBJECTIVE: This study aimed to develop a tailored elastic band exercise program for aged adults (persons 65 years and older), to evaluate the feasibility of a program, and to determine appropriate elastic band exercise frequencies and preferences of aged adults. METHODS: This study had 2 phases. In phase I, 11 professional experts were consulted to develop the Senior Elastic Band (SEB) exercise program. They responded to detailed description and demonstrations of the program contained on either a hard copy or a DVD. In phase II, 20 participants 65 years or older were interviewed for their feedback on the SEB after participating in 1 month of instructor-led SEB group practice. Both quantitative and qualitative strategies were included in the subject evaluation. The quantitative evaluation results were analyzed using descriptive statistics of mean and SD. The qualitative revision suggestions were critically analyzed and summarized using content analysis to revise the program. RESULTS: Both the experts in phase I and the senior participants in phase II rated the SEB highly and commented that the program was feasible, safe, suitable, and helpful. The participants further suggested practicing SEB 3 times per week for 60 minutes per session in a group of 20 to 29 people. CONCLUSIONS: Based on the feedback from the expert panel, the final SEB included 3 phases with 20 movements. The program took 40 minutes to complete. The SEB program was supported by the 11 experts with 5 professional backgrounds and was well accepted by a small group of community seniors. The participants expressed that the program was feasible, was manageable, and could be helpful to their health promotion.

Feasibility appraisal of an elastic band exercise program for older adults in wheelchairs.

This study appraised the feasibility of an elastic band exercise program for older adults in wheelchairs. A descriptive program review survey was used. A wheelchair-bound senior elastic band (WSEB) exercise program tailored to older adults in wheelchairs was initially developed by a group of 12 experts. A feasibility appraisal survey was administered to 10 older adults in wheelchairs through individual interviews after 4 weeks of the WSEB program. Study participants revealed that the WSEB program was feasible, safe, appropriate, and helpful to them. Participants further suggested practicing the WSEB program 3 times/week for 40 min/session in a group of 15-20 people. The finalized WSEB program has 2 levels: the basic and the advanced WSEB program. It is suggested that the basic level to be taught first with practice until participants are familiar with those exercises before proceeding to the advanced level.

Acupressure improves sleep quality of psychogeriatric inpatients.

BACKGROUND: Acupressure, a noninvasive form of acupuncture, may be used as a low-cost and noninvasive means of improving sleep quality. Although it has been evaluated to improve self-reported sleep quality, it has not been assessed with regard to effectiveness in improving perceived and objective measures of sleep quality outcomes. OBJECTIVES: The aim of this study was to investigate the effectiveness of acupressure in improving sleep quality of psychogeriatric inpatients. METHODS: Using a convenience sample, 60 psychogeriatric inpatients with affective disorders from southern Taiwan were recruited. They were assigned randomly to an experimental or control group. Although both groups received standard medical care, those in the experimental group received 9-minute acupressure treatment daily for 4 consecutive weeks. Acupressure was applied to three acupoints: shenmen, yangchuan, and neiguan. Outcomes were measured using the Pittsburgh Sleep Quality Index and actigraphy. Data were collected at baseline and after 4 weeks of intervention. RESULTS: Participants in the experimental group improved significantly in subjective sleep quality as measured by the Pittsburgh Sleep Quality Index and in objective sleep quality as measured by actigraphy (p < .001 for all) after 4 weeks of intervention. Although the control participants also had some improvement in sleep quality, those in the experimental group had significantly greater improvements (p < .05) in all domains of subjective and objective sleep quality than the control group. DISCUSSION: Acupressure may be an effective means of improving sleep quality of psychogeriatric inpatients.

Effectiveness of Qigong in promoting the health of wheelchair-bound older adults in long-term care facilities.

Institutional wheelchair-bound older adults often do not get regular exercise and are prone to health problems. The aim of this study was to test the effects of a 12-week qigong exercise program on the physiological and psychological health of wheelchair-bound older adults in long-term care facilities. Study design was quasi-experimental, pre-post test, nonequivalent control group. Participants comprised a convenience sample of 72 wheelchair-bound older adults (qigong = 34; control = 38). The qigong group exercised 35 min/day, 5 days/week for 12 weeks. Measures for physical health (blood pressure, heart rate variability, and distal skin temperature) and psychological health (Brief Symptom Rating Scale-5) were collected before and during study Weeks 4, 8, and 12. The qigong group participants' blood pressure, distal skin temperature, and psychological health were significantly improved (all p < .001). These findings suggest that qigong exercise is a suitable daily activity for elderly residents in long-term care facilities and may help in the control of blood pressure among older adults.

Using silver yoga exercises to promote physical and mental health of elders with dementia in long-term care facilities.

BACKGROUND: This study aimed to test the effects of yoga exercises on the physical and mental health of elderly people with dementia living in long-term care facilities. METHODS: A quasi-experimental, pretest-post-test design was used. A convenience sample of 68 residents in long-term care facilities in southern Taiwan, aged 60 years and above with mild to moderate dementia, was selected. An experimental group of 33 elders participated in a 12-week yoga training program of three 55-minute sessions a week; a control group of 35 elders maintained their usual daily activities. Data were collected before and after completing the 12-week study. Measurements included body composition, cardiopulmonary functions, body flexibility, muscle strength and endurance, balance, joints motion, depression, and problem behaviors. RESULTS: The yoga-trained participants had better physical and mental health than those who did not participate, including lowered blood pressure, reduced respiration rate, strengthened cardiopulmonary fitness, enhanced body flexibility, improved muscle strength and endurance, improved balance, and increased joints motion (all p values < 0.05). In addition, the depression state (p < 0.001) and problem behaviors (p < 0.001) of these demented elders were significantly reduced. CONCLUSION: Yoga exercise has positive benefits for both the physical and mental health of elders with dementia living in long-term care facilities. It is recommended that yoga be included as one of the routine activities in these long-term care facilities.

Community vs. institutional elders' evaluations of and preferences for yoga exercises.

AIMS: To evaluate and compare the appropriateness of the Silver Yoga exercise programme for community and institutional elders and to determine their preferences towards yoga exercises. BACKGROUND: Yoga has been used to promote the health of elders. The Silver Yoga was developed to accommodate the physical tolerance and body flexibility of elders and applied to community and institutional elders with positive health promotion benefits. DESIGN: Descriptive design with quantitative programme evaluation and semi-structured interviews. METHOD: A convenience sample of 97 participants (64 community elders; 33 institutional elders) was interviewed individually after six months of Silver Yoga exercises. Participants rated the level of difficulty, acceptability, feasibility and helpfulness of the Silver Yoga programme (four phases: warm-up, hatha yoga, relaxation and guided-imagery meditation) and the abdominal breathing technique, based on a 10-point Cantril ladder scale. Further, participants expressed their preferences of yoga exercises based on four open-ended questions. RESULTS: The programme was fairly acceptable, feasible and helpful for community and institutional elders (means ranged from 8·33-9·70). The warm-up, relaxation, guided-imagery meditation and abdominal breathing are fairly easy to follow and perform (means ranged from 0·20-0·94). However, the postures in hatha yoga phase were relatively challenging but still manageable for the institutional elders (mean = 1·97, SD 2·33). Further, community elders preferred to practise yoga 61-90 minutes everyday in a group of 11-20, while the institutional elders preferred to practise yoga 31-60 minutes three times per week, in a group of <10. CONCLUSIONS: The Silver Yoga exercise programme is acceptable, feasible, helpful and manageable for community and institutional elders. However, different exercise protocols, such as practice intensity and group size, could be applied to different older populations. RELEVANCE TO CLINICAL PRACTICE: The Silver Yoga exercise programme could be applied to both community and institutional elders to promote their health.

Silver yoga exercises improved physical fitness of transitional frail elders.

BACKGROUND: Promoting the health of transitional frail elders (e.g., through therapeutic-based yoga exercises) is essential to reduce healthcare expenditures caused by chronic health problems. OBJECTIVE: The purpose of this study was to determine the efficacy of 24 weeks of the senior-tailored silver yoga (SY) exercise program for transitional frail elders. METHODS: A convenience sample of 69 elders in assisted living facilities were assigned randomly to the SY group (n = 38) or to the control group (n = 31) on the basis of the facilities where they resided, and 55 of them completed this quasi-experimental pretest and posttest study. Intervention was conducted three times per week, 70 minutes per session, for 24 weeks. Physical fitness (body composition, cardiovascular-respiratory functions, body flexibility, muscle power and endurance, balance, and agility) were examined at baseline, at 12 weeks, and at the end of the 24th week of the study. RESULTS: At the end of the study, the physical fitness indicators of participants in the SY group had improved significantly, and they had better physical fitness than participants in the control group (all p values < .05). DISCUSSION: It was recommended that the SY exercises be incorporated as an activity program in assisted living facilities to promote the physical fitness of transitional frail elders.

Effects of yoga on sleep quality and depression in elders in assisted living facilities.

BACKGROUND: Being relocated to an assisted living facility can result in sleep disturbances and depression in elders. This may be attributed to or worsened by lack of regular physical activity. Appropriate exercise programs may be an important component of quality of life in this group of transitional frail elders. PURPOSE: This study aimed to test the effects of a 6-month yoga exercise program in improving sleep quality and decreasing depression in transitional frail elders living in assisted living facilities. METHODS: A quasi-experimental pretest-and-posttest design was used. A convenience sample of 69 elderly residents of assisted living facilities was divided randomly into a yoga exercise (n = 38) and control group (n = 31) based on residence location. A total of 55 participants completed the study. The intervention was implemented in three small groups, and each practice group was led by two pretrained certified yoga instructors three times per week at 70 min per practice session for 24 weeks. The outcome measures of sleep quality (Pittsburgh Sleep Quality Index) and depression state (Taiwanese Depression Questionnaire) were examined at baseline, at the 12th week, and at the 24th week of the study. RESULTS: After 6 months of performing yoga exercises, participants' overall sleep quality had significantly improved, whereas depression, sleep disturbances, and daytime dysfunction had decreased significantly (p < .05). In addition, participants in the intervention group had better results on all outcome indicators than those of participants in the control group (p < .05). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It is recommended that yoga exercise be incorporated as an activity program in assisted living facilities or in other long-term care facilities to improve sleep quality and decrease depression in institutionalized elders.

[Scientific and holistic therapy perspectives on Qigong practice for elders with cardiovascular disease risk factors].

The ratio of older adults with chronic illnesses has increased due to increased average life spans. The incidence of cardiovascular diseases among older adults has reached 33.26%, becoming the leading chronic disease and second most significant cause of mortality among older adults. Statistics show that the largest proportion of expenditures on prescription pharmaceuticals in the National Health Insurance goes toward the treatment of cardiovascular diseases. In addition, complications resulting from cardiovascular diseases result in burdens of care that impact seriously on the individual, their family, and society. Studies have supported physical activity as the most important behavior in reducing cardiovascular disease risk factors. Qigong, a traditional Chinese therapeutic activity, uses gentle movements of extremities and control of breathing to improve health, enhance vitality and enable bodies, emotion, and spirit to reach optimal performance. Evidence-based research supports the argument that Qigong improves cardiovascular-respiratory function and lipid profile, decreases blood sugar, and relieves anxiety and depression. We suggest developing a safe, convenient, and simple Qigong exercise regimen for older adults at higher risk of cardiovascular diseases to extend their life expectancy and quality of life.

Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial.

BACKGROUND: Sleep disturbances, depression, and low perception of health status are commonly seen in elderly population; however, clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging. Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults. OBJECTIVE: To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially their sleep quality, depression, and self-perception of health status. DESIGN: Cluster randomized trial. SETTINGS: Eight senior activity centers, southern Taiwan. PARTICIPANTS: A sample of 139 participants was recruited, and 128 of them completed the study. INCLUSION CRITERIA: (1) community-dwelling older adults ages 60 and over, (2) no previous training in yoga, (3) able to walk without assistance, (4) cognitively alert based on the Short Portable Mental Status Questionnaire (SPMSQ) score of eight or higher, and (5) independent or mildly dependent in self-care based on a Barthel Index (BI) score of 91 or higher. The mean age of the participants was 69.20 +/- 6.23 years, and the average number of chronic illness was 0.83 +/- 0.90. The average BI score of the participants was 99.92 +/- 0.62, and the mean SPMSQ score was 9.90 +/- 0.30. METHODS: Participants were randomly assigned into either the experimental (n=62) or the control (n=66) group based on attendance at selected senior activity centers. A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group. RESULTS: Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions, and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study. The mental health indicators of the participants in the experimental group were all better than the participants in the control group (all p<.05). CONCLUSIONS: After 6 months of silver yoga exercises, the sleep quality, depression, and health status of older adults were all improved.

Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises.

AIMS AND OBJECTIVES: Promoting physical fitness of young-older adults is essential in reducing healthcare expenditures which would occur in the future for those with chronic health problems. The silver yoga exercise programme was developed to accommodate the reduced body flexibility experienced by many older adults and was critically reviewed by experts and pilot-tested with community-dwelling older adults. This study aimed to test older adults' physical fitness after a 24-week silver yoga exercise programme and to examine whether the programme could be further shortened to fit senior activity centres' programme designs. DESIGN: A quasi-experimental, pre-post tests design was used: baseline, at 12-week and at 24-week periods. METHODS: Convenience samples of 204 subjects were recruited from eight senior activity centres and 176 subjects completed the study. Subjects were randomly assigned into three groups based on the centres: (1) Experiment I: complete silver yoga with stretching and meditation, (2) Experiment II: shortened silver yoga without the guided-imagery meditation and (3) Wait-list control. The interventions were conducted three times per week for 24 weeks. Physical fitness indicators included body compositions, cardiovascular-respiratory functions, physical functions and the range of motion. RESULTS: At the end of the 24-week period, the physical fitness of subjects in Experiments I and II had significantly improved whether or not guided-imagery meditation was used and all had better physical fitness than subjects in the control group (all p < 0.05). CONCLUSIONS: The physical fitness of older adults in both the 70-minute complete silver yoga group and the 55-minute shortened silver yoga group had significantly improved after the interventions. It was recommended that the silver yoga programme be shortened by eliminating the guided-imagery meditation. RELEVANCE TO CLINICAL PRACTICE: The shortened silver yoga exercise programme is recommended to be incorporated as an activity programme in community-settings to promote the physical fitness of older adults.