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IU Health and Wellness

Research and insights from Indiana University

March 9, 2009

IU Health and Wellness for March discusses the following topics:

Yoga's influence on fear of falling for older adults
Condoms and pleasure, men and women report similar troubles
Tips for helping kids avoid or discontinue smokeless tobacco use


Graham King

Older adults reported tremendous benefits from a twice weekly yoga class that was part of a study involving yoga and fear of falling.

Yoga and fear of falling. Indiana University researchers found promising results in an exploratory study involving yoga practice by older adults who expressed a fear of falling. After a 12-week, twice weekly hatha yoga class, taught by a professional yoga therapist, study participants reported a reduced fear of falling, increased lower body flexibility and a reduction in their leisure constraints. Fear of falling is an important public health concern because it can cause older adults -- even those who have not fallen -- to limit their social and physical activity. This effort to avoid falls can create a harmful cycle that can diminish health and quality of life. "Our study found that yoga was a feasible intervention with older adults and that they perceived great benefit from it," said Marieke Van Puymbroeck, assistant professor in the Department of Recreation, Park and Tourism Studies in IU's School of Health, Physical Education and Recreation.

Van Puymbroeck discussed some of her findings this month at the International Association of Yoga Therapists' Symposium for Yoga Therapy and Research in Los Angeles and will discuss her findings further at conferences hosted by the American Geriatrics Society and the American Therapeutic Recreation Association. More about the study:

  • The study involved 14 men and women with an average age of 78. Five participants had fallen previously.
  • Van Puymbroeck said the 90 percent weekly attendance rate was notable, as was the 6 percent dropout rate, which she said was much lower than most physical activity and yoga studies. The participants took a class in hatha yoga, which is a gentle form of yoga that easily can be adapted for individual needs and can be performed from a seated position. The twice weekly classes each lasted 60 minutes.
  • After the 12-week class, participants reported a 6 percent reduction in their fear of falling, a 34 percent increase in lower body flexibility, and a statistically significant reduction in leisure constraints.
  • Van Puymbroeck said participants reported "tremendous benefits," with emerging themes that included the ability to generalize principals of posture to other situations, increased range of motion, increased flexibility and improved balance.

Co-investigators include David Koceja, Department of Kinesiology in IU Bloomington's School of HPER; and Arlene Schmid, Department of Occupational Therapy and Department of Veterans Affairs, Indiana University-Purdue University Indianapolis.

Van Puymbroeck can be reached at 812-855-3093 Top


Condoms and pleasure. An examination of condom use "turn offs" found that women reported similar problems related to pleasure as men. "This counters the belief that only men have problems with condoms relative to pleasure and orgasm," said William L. Yarber, senior director of the Rural Center for AIDS/STD Prevention at Indiana University and a senior research fellow of the Kinsey Institute. "It shows that condom use is nearly as much an issue for women as for men. Hence, educational efforts need to be directed at both genders. Most of the physical and psychological turn offs can be dealt with educationally and aren't so much associated with the condom itself, like its taste or smell." When condoms are used correctly and consistently they are highly effective in preventing unplanned pregnancies and reducing the risk of sexually transmitted diseases. Yarber is part of a Kinsey Institute-affiliated research team that has published more than 20 research articles as the team explores issues associated with condom misuse. This is the first study, however, that assessed specific "turn offs" related to condom use among men and women. Yarber said understanding the influence of pleasure, in addition to such issues as convenience and comfort of condom use, is critical because problems involving pleasure and orgasm could deter both genders from using condoms. "If something is a significant barrier to pleasure, this has to be addressed," he said. The article, "Condom 'turn offs' among adults: an exploratory study," was published in the International Journal of STD & AIDS.

More about the study:

  • The study involved survey responses from 464 men and women, average age 35, who reported that condoms were a cause of physical or psychological turn off the last time they were used.
  • Regardless of gender, age, education and marital status, three related turn offs were commonly reported: condoms just don't feel right, condoms decrease 'my' sensation, and condoms decrease 'my partner's' sensation.
  • The researchers found no gender difference in responses to four questions addressing arousal and orgasm problems reported by respondents -- regarding themselves and their partners.
  • Participants were recruited from an electronic mailing list for a large, Internet-based company that sells sexual enhancement products. Of the 883 participants who reported having penile-vaginal sex the last time they used condoms during the previous three months, 54 percent of the women and 52 percent of the men reported that condoms were a cause of physical or psychological turn offs the last time they were used.

Yarber and his colleagues say education can address many of these turn offs. Teaching people to use more lubrication, for example, could help address the issue of discomfort, a problem reported primarily by women. "We have tradeoffs in condom use," Yarber said. "They're using condoms for protection from STIs and unplanned pregnancies, but there are problems with comfort and sexual pleasure. You have to look at the gains verses what's given up. We really have to emphasize the gains and encourage couples in their own way to eroticize condom use with the goal of avoiding or minimizing the problems."

Co-authors include Richard Crosby, RCAP, the Kinsey Institute for Research in Sex, Gender and Reproduction, and the College of Public Health at the University of Kentucky; Robin Milhausen, RCAP, The Kinsey Institute and University of Guelph, Ontario; Stephanie A. Sanders, RCAP, Kinsey Institute and Department of Gender Studies at IU; and Cynthia A. Graham, RCAP, The Kinsey Institute and University of Oxford, U.K.

To learn more about the Kinsey Institute-affiliated research team that is exploring condom use issues, visit

Yarber can be reached at 812-855-7974 and Yarber also is a professor in the Department of Applied Health Science in the School of Health, Physical Education and Recreation and the Department of Gender Studies in the College of Arts and Sciences. Top

Journal citation: "Condom 'turn offs' among adults: an exploratory study," International Journal of STD & AIDS 2008; 19: 590-594.

Smokeless tobacco and adolescents. With new indoor air ordinances, cigarette price increases and new smokeless tobacco products available, it is no surprise that adolescents are turning away from cigarettes and increasing use of smokeless tobacco. A report by the U.S. Substance Abuse and Mental Health Services Administration showed a 30 percent increase in the rate of smokeless tobacco use among boys aged 12 to 17 from 2002 to 2007. Data collected by the Indiana Prevention Resource Center at Indiana University Bloomington shows that since 2002, cigarette use by minors has been declining while smokeless tobacco is on the rise. "Smokeless tobacco is not a safe alternative to cigarette use," said Desiree Goetze, researcher at the IPRC. "It causes numerous health problems." Holding one pinch of spit tobacco in the mouth for 30 minutes provides the nicotine equivalent of four cigarettes. Users of spit tobacco are 50 times more likely to develop oral cancers than non-users. More than 60 percent of regular smokeless tobacco users have oral lesions, Leukoplakia, which is a disease of the mouth creating white patches and oral sores on the cheeks, gum and tongue.

The IPRC offers these suggestions to keep kids tobacco free:

  • Start the conversation at an early age. The age of first use of smokeless tobacco is typically around 13. Even 5 or 6 is not too early to begin talking about it.
  • Talk to your child about the health risks of tobacco use. Share a story of a relative or friend who had negative health consequences related to smokeless tobacco use.
  • Explain the specific mouth problems. Smokeless tobacco can stain teeth, rot gums and cause teeth to fall out.
  • If you currently use tobacco, contact a local cessation organization to help you quit. If you continue to use, try not to use in front of your children or make the tobacco accessible to them.
  • Role-play how your child can say "no" when approached by other kids to use smokeless tobacco.
  • Discuss Hollywood's glamorization of tobacco products. Talk to your child about how movies and sports can glamorize the use of tobacco.

If you suspect your child is already using tobacco:

  • Do not use threats or ultimatums
  • Find out why your child is using (peer pressure, weight, status)
  • Work together on finding changes that can be made in your child's life to help him or her stop
  • If you use tobacco, talk to your child about your struggles with the addiction
  • Reward your child for quitting, find something special you can do together to celebrate
  • Have your child make a list of reasons to quit
  • Be supportive, when attempting to quit the cravings can be quite strong. Encourage your child to take deep breaths, go for a walk, drink something or chew sugarless gum, and talk about how he or she is feeling.

Goetze said parental approval is important to youth. Research suggests that the stronger an adolescent perceives that his or her parents disapprove of the behavior, the less likely the youth is to engage in the behavior. Parents should talk with their children about the dangers of smokeless tobacco use, emphasizing that it is not a safe alternative to cigarette use.

Other findings from the IPRC's latest Annual Survey of Alcohol, Tobacco and Other Drugs Used by Indiana Children and Adolescents, include:

  • One third of Indiana 12th-grade males report having used smokeless tobacco in their lifetime.
  • Almost 10 percent of male 12th-graders report daily use of smokeless tobacco.
  • Adolescents in the southeast region of the state had the highest usage rates. This area is primarily rural and includes tobacco producing counties.
  • White youths have the highest rates of smokeless tobacco use among high school students.

Goetze can be reached at 812-855-1237 and The IPRC is part of the Department of Applied Health Science in the School of Health, Physical Education and Recreation. For additional resources visit: or Top

For additional assistance with these media tips, contact Tracy James, University Communications, at 812-855-0084 and