Static and Dynamic Yoga Asanas vs Combined Yoga: Which is More Effective for Enhancing Flexibility and Balance in Perimenopausal Women?
DOI:
https://doi.org/10.17309/tmfv.2026.5.14Keywords:
menopause transition, women’s health, quality of life, physical functionAbstract
Background. Perimenopause is often accompanied by declines in flexibility and balance, increasing the risk of falls and reducing quality of life. Static and dynamic yoga are each linked to gains in flexibility and postural stability, but no study has directly compared static, dynamic, and combined yoga to determine which approach most effectively improves these outcomes in perimenopausal women.
Objectives. This study aimed to evaluate the effects of static, dynamic, and combined yoga practices on flexibility and balance in perimenopausal women.
Materials and Methods. A three-arm randomized controlled trial allocated 36 perimenopausal women (1:1:1) to static, dynamic, or combined yoga, delivered over six weeks (two 50-minute sessions per week). Flexibility was measured with the sit-and-reach test (cm). Balance was measured with a timed beam-crossing test: participants crossed a 2.5 m wooden beam at a self-selected pace, and crossing time (s; 60-second cap) was converted to a balance score (60 − crossing time, in seconds); higher scores indicated better balance. The primary analysis was ANCOVA on post-test scores, controlling for baseline (pre-test) values.
Results. Groups were equivalent at baseline (both p > 0.19). After controlling for baseline scores (ANCOVA), the combined group showed significantly greater post-intervention flexibility and balance than the static group (both p ≤ 0.001) and the dynamic group (flexibility, p = 0.007; balance, p < 0.001). No significant difference was observed between static and dynamic yoga for either outcome (flexibility, p = 0.34; balance, p > 0.99; Bonferroni-adjusted); given the small per-group sample (n = 12), the study was underpowered to detect this contrast, and equivalence should not be inferred.
Conclusions. Combined static-dynamic yoga produced greater gains in flexibility and balance than either modality alone in perimenopausal women. These findings suggest that combined yoga programs are a promising non-pharmacological option for community-based physical activity strategies in this population; effects on fall incidence and quality of life were not directly assessed and warrant dedicated future study.
Downloads
References
Iwanowicz-Palus, G., Świst, D., Skurzak, A., Polska, P., & Stobnicka, D. (2019). Impact of menopause on women’s health. Medycyna Ogólna i Nauki o Zdrowiu, 25(1), 1–5. https://doi.org/10.26444/monz/105617 DOI: https://doi.org/10.26444/monz/105617
Martin-Key, N. A., Funnell, E. L., Spadaro, B., & Bahn, S. (2023). Perceptions of healthcare provision throughout the menopause in the UK: A mixed-methods study. npj Women’s Health, 1(1), 2. https://doi.org/10.1038/s44294-023-00002-y DOI: https://doi.org/10.1038/s44294-023-00002-y
Gothe, N. P., & McAuley, E. (2016). Yoga is as good as stretching–strengthening exercises in improving functional fitness outcomes: Results from a randomized controlled trial. The Journals of Gerontology: Series A, 71(3), 406–411. https://doi.org/10.1093/gerona/glv127 DOI: https://doi.org/10.1093/gerona/glv127
Krejčí, M., Hill, M., Kajzar, J., Tichý, M., & Hošek, V. (2022). Yoga exercise intervention improves balance control and prevents falls in seniors aged 65+. Slovenian Journal of Public Health, 61(2), 85–92. https://doi.org/10.2478/sjph-2022-0012 DOI: https://doi.org/10.2478/sjph-2022-0012
Mancapara, I. G. P. M. (2018). Peranan asana dalam anatomi sistematik. Jurnal Yoga dan Kesehatan, 1(1), 55–64. https://doi.org/10.25078/jyk.v1i1.1544 DOI: https://doi.org/10.25078/jyk.v1i1.1544
Khajuria, A., Kumar, A., Joshi, D., & Kumaran, S. S. (2023). Reducing stress with yoga: A systematic review based on multimodal biosignals. International Journal of Yoga, 16(3), 156–170. https://doi.org/10.4103/ijoy.ijoy_218_23 DOI: https://doi.org/10.4103/ijoy.ijoy_218_23
Cramer, H., Lauche, R., Langhorst, J., & Dobos, G. (2012). Effectiveness of yoga for menopausal symptoms: A systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine, 2012, 863905. https://doi.org/10.1155/2012/863905 DOI: https://doi.org/10.1155/2012/863905
Wang, W.-L., Chen, K.-H., Pan, Y.-C., Yang, S.-N., & Chan, Y.-Y. (2020). The effect of yoga on sleep quality and insomnia in women with sleep problems: A systematic review and meta-analysis. BMC Psychiatry, 20(1), 195. https://doi.org/10.1186/s12888-020-02566-4 DOI: https://doi.org/10.1186/s12888-020-02566-4
Huang, T.-C., Li, C., & Hsieh, C.-Y. (2025). The effects of yoga on fall-related physical functions for older women: A systematic review of randomized controlled trials. Healthcare, 13(2), 124. https://doi.org/10.3390/healthcare13020124 DOI: https://doi.org/10.3390/healthcare13020124
Shete, S., Verma, A., Bhogal, R. S., & Tiwari, S. (2026). Effect of yoga practices on postural stability, fall risk, and psychological wellbeing in older adults. Geriatrics, 11(1), 16. https://doi.org/10.3390/geriatrics11010016 DOI: https://doi.org/10.3390/geriatrics11010016
Golding, L. A., Myers, C. R., & Sinning, W. E. (Eds.). (1982). The Y’s way to physical fitness: A guide book for instructors. Human Kinetics.
Muehlbauer, T., Eckardt, L., Höptner, L., & Hill, M. W. (2024). Effect of low versus high balance training complexity on balance performance in male adolescents. BMC Research Notes, 17(1), 149. https://doi.org/10.1186/s13104-024-06811-x DOI: https://doi.org/10.1186/s13104-024-06811-x
Luo, X., & Huang, X. (2023). The effects of a yoga intervention on balance and flexibility in female college students during COVID-19: A randomized controlled trial. PLOS ONE, 18(3), e0282260. https://doi.org/10.1371/journal.pone.0282260 DOI: https://doi.org/10.1371/journal.pone.0282260
Naragatti, S. (2025). The role of yoga in balancing hormones: A comprehensive research review. International Journal for Multidisciplinary Research, 7(1), 1–12. https://doi.org/10.36948/ijfmr.2025.v07i01.36061 DOI: https://doi.org/10.36948/ijfmr.2025.v07i01.36061
Matsuo, S., Iwata, M., Miyazaki, M., Fukaya, T., Yamanaka, E., Nagata, K., Tsuchida, W., Asai, Y., & Suzuki, S. (2019). Changes in flexibility and force are not different after static versus dynamic stretching. Sports Medicine International Open, 3(3), E89–E95. https://doi.org/10.1055/a-1001-1993 DOI: https://doi.org/10.1055/a-1001-1993
Shin, S. (2021). Meta-analysis of the effect of yoga practice on physical fitness in the elderly. International Journal of Environmental Research and Public Health, 18(21), 11663. https://doi.org/10.3390/ijerph182111663 DOI: https://doi.org/10.3390/ijerph182111663
Liu, X., Zhang, X., Wang, D., Zhou, J., & Li, Y. (2025). Investigation of the quality of life and influencing factors among perimenopausal women. Archives of Gynecology and Obstetrics, 312(4), 1253–1265. https://doi.org/10.1007/s00404-025-08116-1 DOI: https://doi.org/10.1007/s00404-025-08116-1
Liu, X.-Y., Peng, S.-Z., Pei, M.-Y., & Zhang, P. (2023). The effects of physical activity on depression and quality of life in Chinese perimenopausal women. Journal of Affective Disorders, 328, 153–162. https://doi.org/10.1016/j.jad.2023.02.061 DOI: https://doi.org/10.1016/j.jad.2023.02.061
Abiç, A., & Yilmaz Vefikuluçay, D. (2024). The effect of yoga on menopause symptoms: A randomized controlled trial. Holistic Nursing Practice, 38(3), 138–147. https://doi.org/10.1097/HNP.0000000000000646 DOI: https://doi.org/10.1097/HNP.0000000000000646
Bandyopadhyay, N., Das, T., & Mondal, S. (2025). Practicing Surya Namaskar: A sequence of yogic postures for overall health and wellness among healthy adults. Physical Education Theory and Methodology, 25(2), 416–425. https://doi.org/10.17309/tmfv.2025.2.24 DOI: https://doi.org/10.17309/tmfv.2025.2.24
Ikeda, N., Hiratsuka, K., Inami, T., & Isaka, T. (2026). Effect of 12-week dynamic stretching of hamstrings on joint flexibility and musculoskeletal properties. European Journal of Applied Physiology, 126(9), 4859–4865. https://doi.org/10.1007/s00421-026-06309-3 DOI: https://doi.org/10.1007/s00421-026-06309-3
Warneke, K., Thomas, E., Blazevich, A. J., Afonso, J., Behm, D. G., Marchetti, P. H., Trajano, G. S., Nakamura, M., Ayala, F., Longo, S., Babault, N., Freitas, S. R., Costa, P. B., Konrad, A., Nordez, A., Nelson, A., Zech, A., Kay, A. D., Donti, O., & Wilke, J. (2025). Practical recommendations on stretching exercise: A Delphi consensus statement of international research experts. Journal of Sport and Health Science, 14, 101067. https://doi.org/10.1016/j.jshs.2025.101067 DOI: https://doi.org/10.1016/j.jshs.2025.101067
Bindawas, S. M., Vennu, V., Almarwani, M., Alsaleh, H. M., & Alsaad, S. M. (2026). Effectiveness of mobile health application-based interventions for fall prevention in community-dwelling older adults: A systematic review and meta-analysis of randomized controlled trials. Sensors, 26(3), 864. https://doi.org/10.3390/s26030864 DOI: https://doi.org/10.3390/s26030864
Zhong, Y.-J., Meng, Q., & Su, C.-H. (2024). Mechanism-driven strategies for reducing fall risk in the elderly: A multidisciplinary review of exercise interventions. Healthcare, 12(23), 2394. https://doi.org/10.3390/healthcare12232394 DOI: https://doi.org/10.3390/healthcare12232394
Starrach, T., Santl, A., & Seifert-Klauss, V. R. (2022). Perimenopausal bone loss is associated with ovulatory activity—Results of the PeKnO study (Perimenopausal Bone Density and Ovulation). Diagnostics, 12(2), 305. https://doi.org/10.3390/diagnostics12020305 DOI: https://doi.org/10.3390/diagnostics12020305
Wei, F., Hu, Z., He, R., & Wang, Y. (2023). Effects of balance training on balance and fall efficacy in patients with osteoporosis: A systematic review and meta-analysis with trial sequential analysis. Journal of Rehabilitation Medicine, 55, jrm00390. https://doi.org/10.2340/jrm.v55.4529 DOI: https://doi.org/10.2340/jrm.v55.4529
Jeter, P. E., Haaz Moonaz, S., Bittner, A. K., & Dagnelie, G. (2015). Ashtanga-based yoga therapy increases the sensory contribution to postural stability in visually impaired persons at risk for falls as measured by the Wii Balance Board: A pilot randomized controlled trial. PLOS ONE, 10(6), e0129646. https://doi.org/10.1371/journal.pone.0129646 DOI: https://doi.org/10.1371/journal.pone.0129646
Lin, A.-C., Lin, T.-T., Tan, Y.-K., Pan, W.-R., Shih, C.-J., Lee, C.-J., Chen, S.-F., & Wang, F.-C. (2022). Superior gait symmetry and postural stability among yoga instructors—Inertial measurement unit-based evaluation. Sensors, 22(24), 9683. https://doi.org/10.3390/s22249683 DOI: https://doi.org/10.3390/s22249683
Verma, A., Rathore, V., & Yadav, N. (2023). Yoga for proprioception: A systematic review. Yoga Mimamsa, 55(2), 107–113. https://doi.org/10.4103/ym.ym_37_23 DOI: https://doi.org/10.4103/ym.ym_37_23
Harrington, R. (2025). Effect of yoga style on improvement in flexibility, mobility, and functional movement in healthy adults. The International Journal of Health, Wellness, and Society, 16(1), 49–70. https://doi.org/10.18848/2156-8960/CGP/v16i01/49-70 DOI: https://doi.org/10.18848/2156-8960/CGP/v16i01/49-70
Petty, G., Chapman-Lopez, T. J., Moris, J. M., Timon, C., & Koh, Y. (2022). An evaluation of static and dynamic yoga training programs. International Journal of Exercise Science: Conference Proceedings, 2(14), Article 46. https://digitalcommons.wku.edu/ijesab/vol2/iss14/46
Bhowmik Bhunia, G., & Ray, U. S. (2024). Improvement in muscular strength, body flexibility and balance by yogasana and with reduced detraining effects by yoga breathing maneuvers: A non-randomized controlled study. Journal of Ayurveda and Integrative Medicine, 15(1), 100815. https://doi.org/10.1016/j.jaim.2023.100815 DOI: https://doi.org/10.1016/j.jaim.2023.100815
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.who.int/publications/i/item/9789240015128
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Noortje Anita Kumaat, Yetty Septiani Mustar, Bayu Agung Pramono, Nita Bandyopadhyay, Soni Sulistyarto, Heri Wahyudi
This work is licensed under a Creative Commons Attribution 4.0 International License.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
