1 2698 129 YOGA INTERVENTION AND REMINDER E-MAILS FOR REDUCING CANCER-RELATED FATIGUE - A STUDY PROTOCOL OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: ALMOST 90% OF CANCER PATIENTS SUFFER FROM SYMPTOMS OF FATIGUE DURING TREATMENT. SUPPORTING TREATMENTS ARE INCREASINGLY USED TO ALLEVIATE THE BURDEN OF FATIGUE. THIS STUDY EXAMINES THE SHORT-TERM AND LONG-TERM EFFECTS OF YOGA ON FATIGUE AND THE EFFECT OF WEEKLY REMINDER E-MAILS ON EXERCISE FREQUENCY AND FATIGUE SYMPTOMS. METHODS: THE AIM OF THE FIRST PART OF THE STUDY WILL EVALUATE THE EFFECTIVENESS OF YOGA FOR CANCER PATIENTS WITH MIXED DIAGNOSES REPORTING FATIGUE. WE WILL RANDOMLY ALLOCATE 128 PATIENTS TO AN INTERVENTION GROUP (N = 64) RECEIVING YOGA AND A WAIT-LIST CONTROL GROUP (N = 64) RECEIVING YOGA 9 WEEKS LATER. THE YOGA THERAPY WILL BE PERFORMED IN WEEKLY SESSIONS OF 60 MIN EACH FOR 8 WEEKS. THE PRIMARY OUTCOME WILL BE SELF-REPORTED FATIGUE SYMPTOMS. IN THE SECOND PART OF THE STUDY, THE EFFECTIVENESS OF REMINDER E-MAILS WITH REGARD TO THE EXERCISE FREQUENCY AND SELF-REPORTED FATIGUE SYMPTOMS WILL BE EVALUATED. A RANDOMIZED ALLOCATED GROUP OF THE PARTICIPANTS ("EMAIL") RECEIVES WEEKLY REMINDER E-MAILS, THE OTHER GROUP DOES NOT. DATA WILL BE ASSESSED USING QUESTIONNAIRES THE BEGINNING AND AFTER YOGA THERAPY AS WELL AS AFTER 6 MONTHS. DISCUSSION: SUPPORT OF PATIENTS SUFFERING FROM FATIGUE IS AN IMPORTANT GOAL IN CANCER PATIENTS CARE. IF YOGA THERAPY WILL REDUCE FATIGUE, THIS TYPE OF THERAPY MAY BE INTRODUCED INTO ROUTINE PRACTICE. IF THE REMINDER E-MAILS PROVE TO BE HELPFUL, NEW OFFERS FOR PATIENTS MAY ALSO DEVELOP FROM THIS. TRIAL REGISTRATION: GERMAN CLINCIAL TRIALS REGISTER ( DRKS00016034 , 12/2018), RETROSPECTIVELY REGISTERED. 2019 2 2808 41 YOGA THERAPY TO REDUCE FATIGUE IN CANCER: EFFECTS OF REMINDER E-MAILS AND LONG-TERM EFFICACY. OBJECTIVE: TO EXAMINE THE EFFICACY OF REMINDER E-MAILS TO CONTINUE YOGA THERAPY ON PRACTICE FREQUENCY AND FATIGUE IN CANCER PATIENTS AND LONG-TERM EFFECTS OF YOGA ON FATIGUE, DEPRESSION, AND QUALITY OF LIFE. METHODOLOGY: ONE HUNDRED TWO CANCER PATIENTS WHO COMPLETED AN 8-WEEK YOGA THERAPY WERE RANDOMLY ALLOCATED TO TWO GROUPS: REMINDER (N = 51) VS. NO-REMINDER GROUP (N = 51). AFTER COMPLETING YOGA THERAPY, THE REMINDER GROUP RECEIVED WEEKLY E-MAILS FOR 24 WEEKS, WHICH REMINDED THEM OF PRACTICING YOGA, WHEREAS THE NO-REMINDER GROUP DID NOT. PRIMARY OUTCOMES WERE FATIGUE AND PRACTICE FREQUENCY, AND LONG-TERM OUTCOMES WERE FATIGUE, DEPRESSION, AND QUALITY OF LIFE. DATA WERE ASSESSED USING QUESTIONNAIRES AFTER YOGA THERAPY (T1) AND 6 MONTHS AFTER COMPLETING YOGA THERAPY (T2). RESULT: A SIGNIFICANTLY STRONGER REDUCTION OF GENERAL (P = 0.038, D = 0.42) AND EMOTIONAL FATIGUE (P = 0.004, D = 0.59) AND A HIGHER INCREASE OF PRACTICE FREQUENCY (P = 0.015, D = 0.52) BETWEEN T1 AND T2 WERE FOUND FOR THE REMINDER GROUP COMPARED TO THE NO-REMINDER GROUP. IN THE MEDIATION MODEL, PRACTICE FREQUENCY AS A MEDIATOR PARTIALLY EXPLAINED THE CHANGES IN EMOTIONAL FATIGUE (INDIRECT EFFECT B = - 0.10). LONG-TERM EFFECTS OF YOGA THERAPY REGARDING FATIGUE, DEPRESSION, AND QUALITY OF LIFE WERE FOUND (F > 7.46, P < 0.001, D > 0.54). CONCLUSION: WEEKLY REMINDER E-MAILS AFTER YOGA THERAPY CAN POSITIVELY AFFECT GENERAL AND EMOTIONAL FATIGUE AND HELP CANCER PATIENTS WITH FATIGUE ESTABLISH A REGULAR YOGA PRACTICE AT HOME. HOWEVER, HIGHER PRACTICE FREQUENCY DID NOT LEAD TO HIGHER PHYSICAL OR COGNITIVE FATIGUE IMPROVEMENT, SUGGESTING OTHER FACTORS THAT MEDIATE EFFICACY ON PHYSICAL OR COGNITIVE FATIGUE, SUCH AS MINDFULNESS OR SIDE EFFECTS OF THERAPY. 2021 3 1556 49 LONG-TERM CHANGES OF SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE IN CANCER PATIENTS 6 MONTHS AFTER THE END OF YOGA THERAPY. BACKGROUND: SYMPTOMS OF ANXIETY, DEPRESSION, AND CANCER-RELATED FATIGUE ARE COMMONLY ASSOCIATED WITH CANCER. CANCER PATIENTS INCREASINGLY USE COMPLEMENTARY AND ALTERNATIVE TREATMENTS, SUCH AS YOGA, TO COPE WITH PSYCHOLOGICAL AND PHYSICAL IMPAIRMENTS. IN THE PRESENT ARTICLE, LONG-TERM CHANGES OF ANXIETY, DEPRESSION, AND FATIGUE IN CANCER ARE EXAMINED 6 MONTHS AFTER A YOGA INTERVENTION. METHOD: WE USED AN OBSERVATIONAL DESIGN BASED ON A RANDOMIZED CONTROLLED STUDY IN CANCER PATIENTS WITH MIXED DIAGNOSES TO EVALUATE LONG-TERM CHANGES OF SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE 6 MONTHS AFTER THE END OF YOGA THERAPY. WE MEASURED ANXIETY SYMPTOMS WITH THE GENERALIZED ANXIETY DISORDER SCALE (GAD-7), DEPRESSIVE SYMPTOMS WITH THE PATIENT HEALTH QUESTIONNAIRE-2 (PHQ-2), AND FATIGUE WITH THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER QUALITY OF LIFE QUESTIONNAIRE-FATIGUE SCALE (EORTC QLQ-FA13). YOGA THERAPY WAS PROVIDED IN YOGA CLASSES OF 60 MINUTES EACH ONCE A WEEK FOR 8 WEEKS IN TOTAL. THE EXERCISES PROVIDED CONTAINED BOTH BODY AND BREATHING ACTIVITIES AS WELL AS MEDITATION. RESULTS: A TOTAL OF 58 PATIENTS PARTICIPATED IN THE STUDY. SIX MONTHS AFTER THE END OF YOGA THERAPY, SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE WERE SIGNIFICANTLY REDUCED COMPARED WITH BASELINE. HOWEVER, SYMPTOMS OF ANXIETY AND FATIGUE SLIGHTLY INCREASED DURING THE FOLLOW-UP PERIOD, WHEREAS SYMPTOMS OF DEPRESSION REMAINED STABLE. CONCLUSION: OUR RESULTS ARE PROMISING AND SUPPORT THE INTEGRATION OF YOGA INTERVENTIONS IN SUPPORTIVE CANCER TREATMENT CONCEPTS BUT SHOULD BE CONFIRMED BY RANDOMIZED CONTROLLED TRIALS. LONG-TERM EFFECTS OF YOGA THERAPY ON CANCER PATIENTS SHOULD BE THE SUBJECT OF FURTHER RESEARCH. 2019 4 877 53 EFFECT OF YOGA THERAPY ON SYMPTOMS OF ANXIETY IN CANCER PATIENTS. BACKGROUND: MANY CANCER PATIENTS SUFFER FROM SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE. SUPPORTIVE TREATMENTS ARE INCREASINGLY USED TO ALLEVIATE DISTRESS IN CANCER. IN THIS STUDY, THE EFFECTS OF YOGA ON THESE SYMPTOMS ARE EXAMINED. METHODS: WE PERFORMED A RANDOMIZED CONTROLLED STUDY ON CANCER PATIENTS WITH MIXED DIAGNOSES COMPARING YOGA THERAPY WITH A WAITING LIST CONTROL GROUP. WE MEASURED ANXIETY SYMPTOMS WITH THE GENERAL ANXIETY DISORDER (GAD-7) SCALE, DEPRESSIVE SYMPTOMS WITH THE PATIENT HEALTH QUESTIONNAIRE-2 (PHQ-2), AND FATIGUE WITH THE EUROPEAN ORGANISATION FOR RESEARCH AND TREATMENT OF CANCER FATIGUE SCALE (EORTC QLQ-FA13). YOGA THERAPY WAS CARRIED OUT IN WEEKLY SESSIONS OF 60 MIN EACH FOR 8 WEEKS. THE PROGRAM PROVIDED RESTRAINED BODY AND BREATHING EXERCISES AS WELL AS MEDITATION. THE CONTROL GROUP DID NOT RECEIVE ANY YOGA THERAPY WHILE ON THE WAITING LIST. RESULTS: A TOTAL OF 70 SUBJECTS PARTICIPATED IN THE STUDY. ANXIETY WAS SIGNIFICANTLY REDUCED BY THE YOGA THERAPY IN THE INTERVENTION GROUP COMPARED TO THE CONTROL GROUP (P = 0.005). HOWEVER, YOGA THERAPY DID NOT SHOW ANY SIGNIFICANT EFFECTS ON DEPRESSION (P = 0.21) AND FATIGUE (P = 0.11) COMPARED TO THE CONTROL GROUP. CONCLUSION: YOGA THERAPY MAY BE USED TO ALLEVIATE ANXIETY SYMPTOMS IN CANCER PATIENTS AND SHOULD BE THE SUBJECT OF FURTHER RESEARCH. 2018 5 2508 45 YOGA BREATHING FOR CANCER CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE: RESULTS OF A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: MANY DEBILITATING SYMPTOMS ARISE FROM CANCER AND ITS TREATMENT THAT ARE OFTEN UNRELIEVED BY ESTABLISHED METHODS. PRANAYAMA, A SERIES OF YOGIC BREATHING TECHNIQUES, MAY IMPROVE CANCER-RELATED SYMPTOMS AND QUALITY OF LIFE, BUT IT HAS NOT BEEN STUDIED FOR THIS PURPOSE. OBJECTIVES: A PILOT STUDY WAS PERFORMED TO EVALUATE FEASIBILITY AND TO TEST THE EFFECTS OF PRANAYAMA ON CANCER-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. DESIGN: THIS WAS A RANDOMIZED CONTROLLED CLINICAL TRIAL COMPARING PRANAYAMA TO USUAL CARE. SETTING: THE STUDY WAS CONDUCTED AT A UNIVERSITY MEDICAL CENTER. SUBJECTS: PATIENTS RECEIVING CANCER CHEMOTHERAPY WERE RANDOMIZED TO RECEIVE PRANAYAMA IMMEDIATELY OR AFTER A WAITING PERIOD (CONTROL GROUP). INTERVENTIONS: THE PRANAYAMA INTERVENTION CONSISTED OF FOUR BREATHING TECHNIQUES TAUGHT IN WEEKLY CLASSES AND PRACTICED AT HOME. THE TREATMENT GROUP RECEIVED PRANAYAMA DURING TWO CONSECUTIVE CYCLES OF CHEMOTHERAPY. THE CONTROL GROUP RECEIVED USUAL CARE DURING THEIR FIRST CYCLE, AND RECEIVED PRANAYAMA DURING THEIR SECOND CYCLE OF CHEMOTHERAPY. OUTCOME MEASURES: FEASIBILITY, CANCER-ASSOCIATED SYMPTOMS (FATIGUE, SLEEP DISTURBANCE, ANXIETY, DEPRESSION, STRESS), AND QUALITY OF LIFE WERE THE OUTCOMES. RESULTS: CLASS ATTENDANCE WAS NEARLY 100% IN BOTH GROUPS. SIXTEEN (16) PARTICIPANTS WERE INCLUDED IN THE FINAL INTENT-TO-TREAT ANALYSES. THE REPEATED-MEASURES ANALYSES DEMONSTRATED THAT ANY INCREASE IN PRANAYAMA DOSE, WITH DOSE MEASURED IN THE NUMBER OF HOURS PRACTICED IN CLASS OR AT HOME, RESULTED IN IMPROVED SYMPTOM AND QUALITY-OF-LIFE SCORES. SEVERAL OF THESE ASSOCIATIONS--SLEEP DISTURBANCE (P=0.04), ANXIETY (P=0.04), AND MENTAL QUALITY OF LIFE (P=0.05)--REACHED OR APPROACHED STATISTICAL SIGNIFICANCE. CONCLUSIONS: YOGA BREATHING WAS A FEASIBLE INTERVENTION AMONG PATIENTS WITH CANCER RECEIVING CHEMOTHERAPY. PRANAYAMA MAY IMPROVE SLEEP DISTURBANCE, ANXIETY, AND MENTAL QUALITY OF LIFE. A DOSE-RESPONSE RELATIONSHIP WAS FOUND BETWEEN PRANAYAMA USE AND IMPROVEMENTS IN CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. THESE FINDINGS NEED TO BE CONFIRMED IN A LARGER STUDY. 2012 6 428 32 CAN YOGA HAVE ANY EFFECT ON SHOULDER AND ARM PAIN AND QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER? A RANDOMIZED, CONTROLLED, SINGLE-BLIND TRIAL. OBJECTIVE: TO EXAMINE THE EFFECTS OF YOGA ON SHOULDER AND ARM PAIN, QUALITY OF LIFE (QOL), DEPRESSION, AND PHYSICAL PERFORMANCE IN PATIENTS WITH BREAST CANCER. METHODS: THIS PROSPECTIVE, RANDOMIZED STUDY INCLUDED 42 PATIENTS. THE PATIENTS IN GROUP 1 UNDERWENT A 10-WEEK HATHA YOGA EXERCISE PROGRAM. THE PATIENTS IN GROUP 2 WERE INCLUDED IN A 10-WEEK FOLLOW-UP PROGRAM. OUR PRIMARY ENDPOINT WAS ARM AND SHOULDER PAIN INTENSITY. RESULTS: THE GROUP RECEIVING YOGA SHOWED A SIGNIFICANT IMPROVEMENT IN THEIR PAIN SEVERITY FROM BASELINE TO POST-TREATMENT, AND THESE BENEFITS WERE MAINTAINED AT 2.5 MONTHS POST-TREATMENT. WHEN COMPARED TO THE CONTROL GROUP, THERE WERE NO STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE 2 GROUPS WITH RESPECT TO THE PARAMETERS ASSESSED AT THE END OF WEEK 10. CONCLUSION: YOGA WAS AN EFFECTIVE AND SAFE EXERCISE FOR ALLEVIATING SHOULDER AND ARM PAIN, WHICH IS A COMPLICATION WITH A HIGH PREVALENCE IN PATIENTS WITH BREAST CANCER. 2018 7 2529 54 YOGA EFFECTIVELY REDUCES FATIGUE AND SYMPTOMS OF DEPRESSION IN PATIENTS WITH DIFFERENT TYPES OF CANCER. PURPOSE: EXAMINE THE EFFECTS OF AN 8-WEEK YOGA THERAPY ON FATIGUE IN PATIENTS WITH DIFFERENT TYPES OF CANCER. METHODS: A TOTAL OF 173 CANCER PATIENTS SUFFERING FROM MILD TO SEVERE FATIGUE WERE RANDOMLY ALLOCATED TO YOGA INTERVENTION (N = 84) (IG) VERSUS WAITLIST CONTROL GROUP (CG) (N = 88). YOGA THERAPY CONSISTED OF EIGHT WEEKLY SESSIONS WITH 60 MIN EACH. THE PRIMARY OUTCOME WAS SELF-REPORTED FATIGUE SYMPTOMS. SECONDARY OUTCOMES WERE SYMPTOMS OF DEPRESSION AND QUALITY OF LIFE (QOL). DATA WERE ASSESSED USING QUESTIONNAIRES BEFORE (T0) AND AFTER YOGA THERAPY FOR IG VERSUS WAITING PERIOD FOR CG (T1). RESULTS: A STRONGER REDUCTION OF GENERAL FATIGUE (P = .033), PHYSICAL FATIGUE (P = .048), AND DEPRESSION (P < .001) AS WELL AS A STRONGER INCREASE IN QOL (P = .002) WAS FOUND FOR PATIENTS WHO ATTENDED 7 OR 8 SESSIONS COMPARED WITH CONTROLS. WITHIN THE YOGA GROUP, BOTH HIGHER ATTENDANCE RATE AND LOWER T0-FATIGUE WERE SIGNIFICANT PREDICTORS OF LOWER T1-FATIGUE (P .05) OR ANXIETY (F = 2.7, P > .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: THE 8-WEEK YOGA EXERCISE PROGRAM DEVELOPED IN THIS STUDY EFFECTIVELY REDUCED FATIGUE IN PATIENTS WITH BREAST CANCER BUT DID NOT REDUCE DEPRESSION OR ANXIETY. ONCOLOGY NURSES SHOULD STRENGTHEN THEIR CLINICAL HEALTH EDUCATION AND APPLY YOGA TO REDUCE THE FATIGUE EXPERIENCED BY PATIENTS WITH BREAST CANCER WHO UNDERGO ADJUVANT CHEMOTHERAPY. 2014 10 70 42 A FEASIBILITY STUDY EXAMINING THE IMPACT OF YOGA ON PSYCHOSOCIAL HEALTH AND SYMPTOMS IN PEDIATRIC OUTPATIENTS RECEIVING CHEMOTHERAPY. PURPOSE: PEDIATRIC CANCER PATIENTS EXPERIENCE SYMPTOMS THAT NEGATIVELY IMPACT QUALITY OF LIFE; YOGA MAY BE AN EFFECTIVE INTERVENTION. THE PRIMARY OBJECTIVE WAS TO DETERMINE THE FEASIBILITY OF A 10-WEEK, WEEKLY INDIVIDUALIZED YOGA INTERVENTION FOR CHILDREN AND ADOLESCENTS RECEIVING OUTPATIENT CANCER THERAPY PRIMARILY DELIVERED REMOTELY USING SKYPE. SECONDARY OBJECTIVES WERE TO DESCRIBE DEPRESSION, ANXIETY, ANGER, FATIGUE, QUALITY OF LIFE, AND SYMPTOMS AT 5 AND 10 WEEKS AFTER ENROLLMENT. METHODS: WE INCLUDED ENGLISH-SPEAKING PATIENTS AGED 10 TO 18 YEARS RECEIVING OUTPATIENT CHEMOTHERAPY FOR CANCER. WEEKLY INDIVIDUALIZED YOGA SESSIONS WERE OFFERED FOR 10 WEEKS. WEEKS 1, 5, AND 10 WERE IN-HOSPITAL WHILE THE REMAINING SESSIONS WERE DELIVERED REMOTELY USING SKYPE. TWICE WEEKLY, HOMEWORK WAS ASSIGNED BETWEEN EACH SESSION. THE PRIMARY OUTCOME WAS FEASIBILITY, DEFINED AS 80% OF PARTICIPANTS COMPLETING AT LEAST 60% OF PLANNED IN-HOSPITAL OR REMOTE YOGA SESSIONS. RESULTS: BETWEEN MARCH AND NOVEMBER 2017, 10 PATIENTS WERE ENROLLED. TWO PATIENTS DISCONTINUED THE STUDY AFTER ONE AND TWO SESSIONS. ONLY SIX PARTICIPANTS ACHIEVED AT LEAST 60% OF PLANNED YOGA SESSIONS AND THUS, THE STUDY DID NOT MEET THE A PRIORI DEFINED FEASIBILITY THRESHOLD. AMONG ALL PARTICIPANTS, ONLY ONE HOMEWORK SESSION WAS PERFORMED. CONCLUSIONS: A 10-WEEK INDIVIDUALIZED IN-PERSON AND REMOTELY CONDUCTED YOGA INTERVENTION WAS NOT FEASIBLE IN CHILDREN RECEIVING CANCER TREATMENTS BECAUSE OF FAILURE TO ACHIEVE THE DESIRED FREQUENCY OF YOGA SESSIONS IN A SUFFICIENT NUMBER OF PARTICIPANTS. FUTURE RESEARCH SHOULD IDENTIFY APPROACHES TO IMPROVE COMPLIANCE WITH REMOTE YOGA SESSIONS AND HOME PRACTICE. TRIAL REGISTRATION: NCT03318068. 2019 11 2117 46 THE EFFECT OF YOGA ON WOMEN WITH SECONDARY ARM LYMPHOEDEMA FROM BREAST CANCER TREATMENT. BACKGROUND: WOMEN WHO DEVELOP SECONDARY ARM LYMPHOEDEMA SUBSEQUENT TO TREATMENT ASSOCIATED WITH BREAST CANCER REQUIRE LIFE-LONG MANAGEMENT FOR A RANGE OF SYMPTOMS INCLUDING ARM SWELLING, HEAVINESS, TIGHTNESS IN THE ARM AND SOMETIMES THE CHEST, UPPER BODY IMPAIRMENT AND CHANGES TO A RANGE OF PARAMETERS RELATING TO QUALITY OF LIFE. WHILE EXERCISE UNDER CONTROLLED CONDITIONS HAS HAD POSITIVE OUTCOMES, THE IMPACT OF YOGA HAS NOT BEEN INVESTIGATED. THE AIM OF THIS STUDY IS TO DETERMINE THE EFFECTIVENESS OF YOGA IN THE PHYSICAL AND PSYCHO-SOCIAL DOMAINS, IN THE HOPE THAT WOMEN CAN BE OFFERED ANOTHER SAFE, HOLISTIC MODALITY TO HELP CONTROL MANY, IF NOT ALL, OF THE EFFECTS OF SECONDARY ARM LYMPHOEDEMA. METHODS AND DESIGN: A RANDOMISED CONTROLLED PILOT TRIAL WILL BE CONDUCTED IN HOBART AND LAUNCESTON WITH A TOTAL OF 40 WOMEN RECEIVING EITHER YOGA INTERVENTION OR CURRENT BEST PRACTICE CARE. INTERVENTION WILL CONSIST OF EIGHT WEEKS OF A WEEKLY TEACHER-LED YOGA CLASS WITH A HOME-BASED DAILY YOGA PRACTICE DELIVERED BY DVD. PRIMARY OUTCOME MEASURES WILL BE THE EFFECTS OF YOGA ON LYMPHOEDEMA AND ITS ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. SECONDARY OUTCOME MEASURES WILL BE RANGE OF MOTION OF THE ARM AND THORACIC SPINE, SHOULDER STRENGTH, AND WEEKLY AND DAILY PHYSICAL ACTIVITY. PRIMARY AND SECONDARY OUTCOMES WILL BE MEASURED AT BASELINE, WEEKS FOUR, EIGHT AND A FOUR WEEK FOLLOW UP AT WEEK TWELVE. RANGE OF MOTION OF THE SPINE, IN A SELF-NOMINATED GROUP, WILL BE MEASURED AT BASELINE, WEEKS EIGHT AND TWELVE. A FURTHER OUTCOME WILL BE THE WOMEN'S PERCEPTIONS OF THE YOGA COLLECTED BY INTERVIEW AT WEEK EIGHT. DISCUSSION: THE RESULTS OF THIS TRIAL WILL PROVIDE INFORMATION ON THE SAFETY AND EFFECTIVENESS OF YOGA FOR WOMEN WITH SECONDARY ARM LYMPHOEDEMA FROM BREAST CANCER TREATMENT. IT WILL ALSO INFORM METHODOLOGY FOR FUTURE, LARGER TRIALS. TRIAL REGISTRATION: ACTRN12611000202965. 2012 12 2605 34 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: RESULTS OF A PILOT STUDY. APPROXIMATELY ONE-THIRD OF BREAST CANCER SURVIVORS EXPERIENCES PERSISTENT FATIGUE FOR MONTHS OR YEARS AFTER SUCCESSFUL TREATMENT COMPLETION. THERE IS A LACK OF EVIDENCE-BASED TREATMENTS FOR CANCER-RELATED FATIGUE, PARTICULARLY AMONG CANCER SURVIVORS. THIS SINGLE-ARM PILOT STUDY EVALUATED THE FEASIBILITY AND PRELIMINARY EFFICACY OF A YOGA INTERVENTION FOR FATIGUED BREAST CANCER SURVIVORS BASED ON THE IYENGAR TRADITION. IYENGAR YOGA PRESCRIBES SPECIFIC POSES FOR INDIVIDUALS WITH SPECIFIC MEDICAL PROBLEMS AND CONDITIONS; THIS TRIAL EMPHASIZED POSTURES BELIEVED TO BE EFFECTIVE FOR REDUCING FATIGUE AMONG BREAST CANCER SURVIVORS, INCLUDING INVERSIONS AND BACKBENDS PERFORMED WITH THE SUPPORT OF PROPS. TWELVE WOMEN WERE ENROLLED IN THE TRIAL, AND 11 COMPLETED THE FULL 12-WEEK COURSE OF TREATMENT. THERE WAS A SIGNIFICANT IMPROVEMENT IN FATIGUE SCORES FROM PRE- TO POST-INTERVENTION THAT WAS MAINTAINED AT THE 3-MONTH POST-INTERVENTION FOLLOWUP. SIGNIFICANT IMPROVEMENTS WERE ALSO OBSERVED IN MEASURES OF PHYSICAL FUNCTION, DEPRESSED MOOD, AND QUALITY OF LIFE. THESE RESULTS SUPPORT THE ACCEPTABILITY OF THIS INTERVENTION AND SUGGEST THAT IT MAY HAVE BENEFICIAL EFFECTS ON PERSISTENT POST-TREATMENT FATIGUE. HOWEVER, RESULTS REQUIRE REPLICATION IN A LARGER RANDOMIZED CONTROLLED TRIAL. 2011 13 1242 41 FEASIBILITY OF A YOGA INTERVENTION TO DECREASE PAIN IN OLDER WOMEN: A RANDOMIZED CONTROLLED PILOT STUDY. BACKGROUND: A SIGNIFICANT PROPORTION OF OLDER WOMEN SUFFER FROM CHRONIC PAIN, WHICH CAN DECREASE QUALITY OF LIFE. THE OBJECTIVE OF THIS PILOT RANDOMIZED STUDY WAS TO EVALUATE THE FEASIBILITY OF A FLOW-RESTORATIVE YOGA INTERVENTION DESIGNED TO DECREASE PAIN AND RELATED OUTCOMES AMONG WOMEN AGED 60 OR OLDER. METHODS: FLOW-RESTORATIVE YOGA CLASSES WERE HELD TWICE WEEKLY FOR 1 HOUR AND LED BY A CERTIFIED YOGA INSTRUCTOR. PARTICIPANTS RANDOMIZED TO THE INTERVENTION GROUP ATTENDED THE YOGA CLASSES FOR 12 WEEKS AND RECEIVED SUPPLEMENTAL MATERIALS FOR AT-HOME PRACTICE. THOSE RANDOMIZED TO THE CONTROL GROUP WERE ASKED TO MAINTAIN THEIR NORMAL DAILY ROUTINE. FEASIBILITY WAS EVALUATED USING RECRUITMENT AND RETENTION RATES, CLASS AND HOME PRACTICE ADHERENCE RATES, AND PARTICIPANT SATISFACTION SURVEYS. OUTCOME MEASURES (SELF-REPORTED PAIN, INFLAMMATORY MARKERS, FUNCTIONAL FITNESS, QUALITY OF LIFE, RESILIENCE, AND SELF-REPORTED PHYSICAL ACTIVITY) WERE ASSESSED AT BASELINE AND POST-INTERVENTION. PAIRED T-TESTS OR WILCOXON SIGNED-RANK TESTS WERE USED TO EXAMINE CHANGES IN OUTCOME MEASURES WITHIN TREATMENT GROUPS. RESULTS: THIRTY-EIGHT PARTICIPANTS WERE RECRUITED AND RANDOMIZED. PARTICIPANTS WERE PRIMARILY WHITE, COLLEGE-EDUCATED, AND HIGHER FUNCTIONING, DESPITE EXPERIENCING VARIOUS FORMS OF CHRONIC PAIN. ATTENDANCE AND RETENTION RATES WERE HIGH (91 AND 97%, RESPECTIVELY) AND THE MAJORITY OF PARTICIPANTS WERE SATISFIED WITH THE YOGA PROGRAM (89%) AND WOULD RECOMMEND IT TO OTHERS (87%). INTERVENTION PARTICIPANTS ALSO EXPERIENCED REDUCTIONS IN PAIN INTERFERENCE AND IMPROVEMENTS IN ENERGY AND SOCIAL FUNCTIONING. CONCLUSIONS: THIS PILOT STUDY PROVIDES ESSENTIAL DATA TO INFORM A FULL SCALE RANDOMIZED TRIAL OF FLOW-RESTORATIVE YOGA FOR OLDER WOMEN WITH CHRONIC PAIN. FUTURE STUDIES SHOULD EMPHASIZE STRATEGIES TO RECRUIT A MORE DIVERSE STUDY POPULATION, PARTICULARLY OLDER WOMEN AT HIGHER RISK OF DISABILITY AND FUNCTIONAL DECLINE. TRIAL REGISTRATION: CLINICALTRIALS.GOV , NCT03790098 . REGISTERED 31 DECEMBER 2018 - RETROSPECTIVELY REGISTERED. 2020 14 1106 37 EFFECTS OF YOGA, AEROBIC, AND STRETCHING AND TONING EXERCISES ON COGNITION IN ADULT CANCER SURVIVORS: PROTOCOL OF THE STAY FIT PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER SURVIVORS EXPERIENCE COMPROMISED QUALITY OF LIFE DUE TO IMPAIRED COGNITIVE FUNCTION AS A RESULT OF CANCER DIAGNOSIS AND TREATMENT. ALTHOUGH EXERCISE HAS PROVEN TO BE EFFECTIVE IN IMPROVING COGNITIVE FUNCTION ACROSS THE LIFESPAN, INTERVENTIONS COMPREHENSIVELY TESTING THE EFFECTIVENESS FOR CANCER SURVIVORS ARE LIMITED. THE STAY FIT TRIAL IS A THREE-ARMED PILOT RANDOMIZED CONTROLLED TRIAL DESIGNED TO COMPARE THE EFFECTS OF A 12-WEEK YOGA, AEROBIC WALKING, AND STRETCH AND TONE INTERVENTION ON COGNITIVE FUNCTION AMONG ADULT CANCER SURVIVORS. METHODS: THIS PILOT STUDY AIMS TO RECRUIT 75 ADULT CANCER SURVIVORS WHO WILL COMPLETE ASSESSMENTS OF COGNITIVE FUNCTION, CARDIOVASCULAR FITNESS, PHYSICAL ACTIVITY, AND PSYCHOSOCIAL MEASURES AT BASELINE AND AFTER THE 12-WEEK INTERVENTION. THE AIMS OF STAY FIT ARE (1) TO ASSESS THE EFFICACY OF YOGA TO IMPROVE COGNITIVE FUNCTION AMONG CANCER SURVIVORS, COMPARED TO AEROBIC EXERCISE AND AN ACTIVE CONTROL GROUP; (2) TO EXAMINE CHANGES IN CARDIOVASCULAR FITNESS AS A RESULT OF THE INTERVENTIONS; AND (3) TO ASSESS CHANGES IN QUALITY OF LIFE AMONG OUR POPULATION AS A RESULT OF THE EXERCISE INTERVENTIONS. DISCUSSION: THE STAY FIT TRIAL WILL TEST THE EFFECTIVENESS OF YOGA, AEROBIC EXERCISE, AND STRETCHING AND TONING EXERCISES IN IMPROVING COGNITIVE FUNCTION AND FITNESS AMONG ADULT CANCER SURVIVORS. THE RESULTS OF THIS PILOT STUDY WILL ENABLE US TO UNDERSTAND THE MOST EFFECTIVE PHYSICAL ACTIVITY MODALITY TO IMPROVE COGNITIVE FUNCTION IN THIS POPULATION AND POTENTIALLY COMBAT CANCER-RELATED COGNITIVE IMPAIRMENT. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT03650322 . REGISTERED ON 28 AUGUST 2018. 2020 15 2080 37 THE EFFECT OF GROUP MINDFULNESS - BASED STRESS REDUCTION PROGRAM AND CONSCIOUS YOGA ON THE FATIGUE SEVERITY AND GLOBAL AND SPECIFIC LIFE QUALITY IN WOMEN WITH BREAST CANCER. BACKGROUND: CANCER IS NOT MERELY AN EVENT WITH A CERTAIN END, BUT IT IS A PERMANENT AND VAGUE SITUATION THAT IS DETERMINED BY DELAYED EFFECTS DUE TO THE DISEASE, ITS TREATMENT AND ITS RELATED PSYCHOLOGICAL ISSUES. THE AIM OF THIS STUDY WAS TO EXAMINE THE EFFECTIVENESS OF THE MINDFULNESS-BASED STRESS REDUCTION PROGRAM AND CONSCIOUS YOGA ON THE MENTAL FATIGUE SEVERITY AND LIFE QUALITY OF WOMEN WITH BREAST CANCER. METHODS: THIS WAS A QUASI-EXPERIMENTAL STUDY WITH A PRE-TEST, POST-TEST AND CONTROL GROUP. IN THIS STUDY, 24 PATIENTS WITH THE DIAGNOSIS OF BREAST CANCER WERE SELECTED AMONG THE PATIENTS WHO REFERRED TO THE DIVISION OF ONCOLOGY AND RADIOTHERAPY OF IMAM HOSSEIN HOSPITAL IN TEHRAN USING AVAILABLE SAMPLING METHOD, AND WERE RANDOMLY ASSIGNED INTO THE EXPERIMENTAL AND CONTROL GROUPS. ALL THE PARTICIPANTS COMPLETED THE FATIGUE SEVERITY SCALE, GLOBAL LIFE QUALITY OF CANCER PATIENT AND SPECIFIC LIFE QUALITY OF CANCER PATIENT QUESTIONNAIRES. DATA WERE ANALYZED BY MULTIVARIATE REPEATED MEASUREMENT VARIANCE ANALYSIS MODEL. RESULTS: FINDINGS REVEALED THAT THE MINDFULNESS-BASED STRESS REDUCTION TREATMENT SIGNIFICANTLY IMPROVED THE OVERALL QUALITY OF LIFE, ROLE, COGNITIVE, EMOTION, SOCIAL FUNCTIONS AND PAIN AND FATIGUE SYMPTOMS IN GLOBAL LIFE QUALITY IN THE EXPERIMENTAL GROUP. IT ALSO SIGNIFICANTLY IMPROVED THE BODY IMAGE, FUTURE FUNCTIONS AND THERAPY SIDE EFFECTS IN SPECIFIC LIFE QUALITY OF THE EXPERIMENTAL GROUP COMPARED TO THE CONTROL GROUP. IN ADDITION, FATIGUE SEVERITY CAUSED BY CANCER WAS REDUCED SIGNIFICANTLY. CONCLUSION: THE RESULTS SHOWED THAT THE MINDFULNESS - BASED STRESS REDUCTION TREATMENT CAN BE EFFECTIVE IN IMPROVING GLOBAL AND SPECIFIC LIFE QUALITY AND FATIGUE SEVERITY IN WOMEN WITH BREAST CANCER. 2015 16 1233 39 FEASIBILITY AND PRELIMINARY EFFICACY OF TAILORED YOGA IN SURVIVORS OF HEAD AND NECK CANCER: A PILOT STUDY. PURPOSE: TREATMENT FOR HEAD AND NECK CANCER (HNC) RESULTS IN LONG-TERM TOXICITIES AND INCREASED PHYSICAL AND PSYCHOSOCIAL SURVIVOR BURDEN. THERE ARE A LIMITED NUMBER OF TREATMENTS FOR THESE LATE EFFECTS. YOGA POSTURES, BREATH WORK, RELAXATION, AND MEDITATION, MAY IMPROVE THESE LATE EFFECTS. THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE FEASIBILITY OF A TAILORED YOGA PROGRAM IN HNC SURVIVORS AND OBTAIN PRELIMINARY EFFICACY DATA. METHODS: THIS WAS A RANDOMIZED WAIT-LIST CONTROL STUDY OF YOGA-NAIVE HNC SURVIVORS WHO WERE >3 MONTHS POST-CANCER TREATMENT. BASELINE DATA WERE COLLECTED. PARTICIPANTS WERE RANDOMIZED TO EITHER AN 8-WEEK HATHA YOGA INTERVENTION GROUP OR A WAIT-LIST GROUP. FEASIBILITY AND EFFICACY DATA WERE COLLECTED. AT 4 AND 8 WEEKS, PATIENTS UNDERWENT A REPEAT ASSESSMENT OF HEALTH. WAIT-LIST CONTROL GROUP PARTICIPANTS WERE OFFERED THE YOGA PROGRAM AFTER DATA COLLECTION. DESCRIPTIVE STATISTICS EVALUATED FEASIBILITY. MIXED EFFECTS GENERAL LINEAR MODELS WERE USED TO GENERATE ESTIMATES OF THE EFFICACY OUTCOMES. RESULTS: SEVENTY-THREE INDIVIDUALS WERE SCREENED AND 40 WERE ELIGIBLE. ALL ELIGIBLE INDIVIDUALS CONSENTED AND ENROLLED. FIVE OF THE INTERVENTION GROUP DISCONTINUED EARLY AND NONE IN THE WAIT-LIST CONTROL GROUP. FEASIBILITY WAS AFFIRMED AS PARTICIPANTS WERE RECRUITED AND RETAINED IN THE STUDY, THERE WERE NO ADVERSE EVENTS, FIDELITY TO PROTOCOL WAS DEMONSTRATED, AND SATISFACTION RATES WERE HIGH. EFFICACY MEASURES INDICATED POTENTIAL BENEFIT FOR SHOULDER RANGE OF MOTION ( D = 0.57-0.86, P < .05), PAIN ( D = 0.67-0.90, P /= 4 SESSIONS. EIGHTY PERCENT OF PARTICIPANTS IN THE YOGA CONDITION AND 65% IN THE SUPPORT GROUP INDICATED THAT THEY WERE HIGHLY SATISFIED WITH THE INTERVENTION. FOLLOWING TREATMENT, WOMEN IN THE YOGA INTERVENTION HAD MODEST IMPROVEMENTS IN SOME OUTCOMES; HOWEVER, OVERALL SYMPTOM LEVELS WERE LOW FOR WOMEN IN BOTH CONDITIONS. CONCLUSIONS: FINDINGS SUGGEST THAT THE YOGA INTERVENTION CONTENT WAS HIGHLY ACCEPTABLE TO PATIENTS WITH MBC, BUT THAT THERE ARE CHALLENGES TO IMPLEMENTING AN INTERVENTION INVOLVING EIGHT GROUP-BASED IN-PERSON SESSIONS. ALTERNATIVE MODES OF DELIVERY MAY BE NECESSARY TO REACH PATIENTS MOST IN NEED OF INTERVENTION. 2019 19 282 37 ADHERENCE TO YOGA AND EXERCISE INTERVENTIONS IN A 6-MONTH CLINICAL TRIAL. 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. 2007 20 2442 36 YOGA AND SELF-REPORTED COGNITIVE PROBLEMS IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: CANCER SURVIVORS OFTEN REPORT COGNITIVE PROBLEMS. FURTHERMORE, DECREASES IN PHYSICAL ACTIVITY TYPICALLY OCCUR OVER THE COURSE OF CANCER TREATMENT. ALTHOUGH PHYSICAL ACTIVITY BENEFITS COGNITIVE FUNCTION IN NONCANCER POPULATIONS, EVIDENCE LINKING PHYSICAL ACTIVITY TO COGNITIVE FUNCTION IN CANCER SURVIVORS IS LIMITED. IN OUR RECENT RANDOMIZED CONTROLLED TRIAL, BREAST CANCER SURVIVORS WHO RECEIVED A YOGA INTERVENTION HAD LOWER FATIGUE AND INFLAMMATION FOLLOWING THE TRIAL COMPARED WITH A WAIT LIST CONTROL GROUP. THIS SECONDARY ANALYSIS OF THE PARENT TRIAL ADDRESSED YOGA'S IMPACT ON COGNITIVE COMPLAINTS. METHODS: POSTTREATMENT STAGE 0-IIIA BREAST CANCER SURVIVORS (N = 200) WERE RANDOMIZED TO A 12-WEEK, TWICE-WEEKLY HATHA YOGA INTERVENTION OR A WAIT LIST CONTROL GROUP. PARTICIPANTS REPORTED COGNITIVE COMPLAINTS USING THE BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE AT BASELINE, IMMEDIATELY POSTINTERVENTION, AND 3-MONTH FOLLOW-UP. RESULTS: COGNITIVE COMPLAINTS DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS IMMEDIATELY POSTINTERVENTION (P = 0.250). HOWEVER, AT 3-MONTH FOLLOW-UP, YOGA PARTICIPANTS' BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE SCORES WERE AN AVERAGE OF 23% LOWER THAN WAIT LIST PARTICIPANTS' SCORES (P = 0.003). THESE GROUP DIFFERENCES IN COGNITIVE COMPLAINTS REMAINED AFTER CONTROLLING FOR PSYCHOLOGICAL DISTRESS, FATIGUE, AND SLEEP QUALITY. CONSISTENT WITH THE PRIMARY RESULTS, THOSE WHO PRACTICED YOGA MORE FREQUENTLY REPORTED SIGNIFICANTLY FEWER COGNITIVE PROBLEMS AT 3-MONTH FOLLOW-UP THAN THOSE WHO PRACTICED LESS FREQUENTLY (P < 0.001). CONCLUSIONS: THESE FINDINGS SUGGEST THAT YOGA CAN EFFECTIVELY REDUCE BREAST CANCER SURVIVORS' COGNITIVE COMPLAINTS AND PROMPT FURTHER RESEARCH ON MIND-BODY AND PHYSICAL ACTIVITY INTERVENTIONS FOR IMPROVING CANCER-RELATED COGNITIVE PROBLEMS. 2015