GYY: The Gentle Years Yoga Trial

An individually randomised controlled, two arm, pragmatic, multi-centre trial to determine the clinical and cost-effectiveness of an adapted yoga programme for older adults with multimorbidity, including an embedded process evaluation 

We undertook a randomised controlled trial to determine the clinical and cost-effectiveness
of a chair-based yoga programme for older adults with multiple long-term health conditions.
The offer of a 12-week Gentle Years Yoga (GYY) programme was not associated with any
significant benefits in terms of quality of life, mental health, loneliness or falls.

Why did we do this research?

Many older adults have multiple long-term health conditions, which can lead to poorer
health outcomes and affect quality of life, with some people experiencing little impact on
their lives and others needing significant healthcare support. Some conditions can be well
controlled with medicines or other treatments, but this is not always the case.

The GYY programme was developed to improve quality of life for older adults, including
those with long-term health conditions. The aims of GYY are to improve muscle strength,
flexibility, balance, mobility, and mental and social wellbeing. There is some evidence
supporting the beneficial effects of yoga in older adults and for several long-term
conditions. However, good quality evidence of the clinical and cost benefits is limited and
little research has specifically focused on older adults with multiple long-term conditions.

What did we do?

Our randomised controlled trial tested whether offering a 12-week course of GYY improved
quality of life, and reduced anxiety, depression, loneliness and falls for people aged 65 years
and over who had two or more long-term health conditions.
The course for those randomised to the GYY programme involved 12, 75-minute sessions of
chair-based yoga, usually delivered weekly, either face-to-face or online. Participants
completed four questionnaires over a 12-month period.
To find out how GYY worked in practice, we undertook one-to-one interviews with some of
the participants and all the yoga teachers. Some yoga sessions were independently
observed to ensure consistency of delivery.
We also carried out four studies within a trial (SWATs) investigating ways to improve trial
methods.

What did we find?

We successfully completed the largest randomised controlled trial of chair-based yoga for
older adults with multiple long-term conditions in the world. Although we found that the
offer of a 12-week GYY programme was not associated with any significant benefits in terms of quality of life,
mental health, loneliness or falls, it was safe, acceptable to most participants, valued by
some, and may be good value for money.

Outputs

Publications

• Ward L, Wiley L, Rose F, et al Yoga for older adults with multimorbidity: teaching insights for optimising participant safety and inclusion from the process evaluation of the Gentle Years Yoga trial BMJ Open 2025;15:e097472. doi: 10.1136/bmjopen-2024-097472
• Ward, L., Bissell, L., Howsam, J. et al. Acceptability and feasibility of online delivery of chair-based yoga for older adults with multimorbidity – lessons from a process evaluation of the gentle years yoga trial. BMC Complement Med Ther 25, 107 (2025). https://doi.org/10.1186/s12906-025-04838-6
• Ward, L., Tew, G.A., Wiley, L. et al. Perceptions and experiences of chair-based yoga by older adults with multimorbidity - a qualitative process evaluation of the Gentle Years Yoga randomised controlled trial. BMC Geriatr 25, 152 (2025). https://doi.org/10.1186/s12877-025-05782-3
• Tew GA, Wiley L, Ward L, Hugill-Jones JG, Maturana CS, Fairhurst CM, et al. Chair-based yoga programme for older adults with multimorbidity: RCT with embedded economic and process evaluations. Health Technol Assess 2024;28(53). https://doi.org/10.3310/KPGN4216
• Tew G, Wiley L, Ward L et al. Effectiveness and cost-effectiveness of offering a chair-based yoga programme in addition to usual care in older adults with multiple long-term conditions: a pragmatic, parallel group, open label, randomised controlled trial [version 1; peer review: awaiting peer review]. NIHR Open Res 2023, 3:52 https://doi.org/10.3310/nihropenres.13465.2
• Fairhurst C, Parkinson G, Hewitt C et al. Enclosing a pen in a postal questionnaire follow-up to increase response rate: a study within a trial [version 2; peer review: 2 approved]. NIHR Open Res 2023, 2:53 https://doi.org/10.3310/nihropenres.13324.2
• Fairhurst C, Roche J, Bissell L et al. A 2x2 randomised factorial SWAT of the use of a pen and small, financial incentive to improve recruitment in a randomised controlled trial of yoga for older adults with multimorbidity [version 2; peer review: 2 approved]. F1000Research 2022, 10:326 https://doi.org/10.12688/f1000research.52164.2
• Tew, G.A., Bissell, L., Corbacho, B. et al. Yoga for older adults with multimorbidity (the Gentle Years Yoga Trial): study protocol for a randomised controlled trial. Trials 22, 269 (2021). https://doi.org/10.1186/s13063-021-05217-5
• Tew, G.A., Howsam, J., Hardy, M. et al. Adapted yoga to improve physical function and health-related quality of life in physically-inactive older adults: a randomised controlled pilot trial. BMC Geriatr 17, 131 (2017). https://doi.org/10.1186/s12877-017-0520-6

Presentations

The GYY Trial results event recording (1 Nov 2023)

https://www.youtube.com/watch?v=11tdDB6OieA

Interviews

Interview with Research Council for Complementary Medicine (20 Oct 2025)

https://www.youtube.com/watch?v=qaymkteQIwU

Other Outputs

Chair-based yoga for older adults with multiple long-term health conditions: a summary
report for participants

GYY Summary Briefing (PDF , 224kb)

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