1 1748 152 PILOT RANDOMIZED, CONTROLLED TRIAL OF A DYADIC YOGA PROGRAM FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS. BACKGROUND: WHILE THE USE OF BEHAVIORAL MEDICINE IN MANAGING GLIOMA PATIENTS' SYMPTOMS IS NOT WELL STUDIED, THE HIGH SYMPTOM BURDEN IN PATIENTS AND THEIR FAMILY CAREGIVERS IS WELL ESTABLISHED. WE CONDUCTED A PILOT RANDOMIZED, CONTROLLED TRIAL TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFICACY OF A DYADIC YOGA (DY) INTERVENTION AS A SUPPORTIVE CARE STRATEGY. METHODS: GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS WERE RANDOMIZED TO A 12-SESSION DY OR WAITLIST CONTROL (WLC) GROUP. PRIOR TO RADIOTHERAPY AND RANDOMIZATION, BOTH GROUPS COMPLETED MEASURES OF CANCER-RELATED SYMPTOMS (MD ANDERSON SYMPTOM INVENTORY-BRAIN TUMOR MODULE), DEPRESSIVE SYMPTOMS (CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION MEASURE), FATIGUE (BRIEF FATIGUE INVENTORY), AND OVERALL QUALITY OF LIFE (QOL; MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM SURVEY). DYADS WERE REASSESSED AT THE LAST DAY OF RADIOTHERAPY. RESULTS: TWENTY PATIENTS (MEAN AGE: 46 YEARS, 50% FEMALE, 80% WHO GRADE IV AND CAREGIVERS (MEAN AGE: 50 YEARS, 70% FEMALE, 50% SPOUSES) PARTICIPATED IN THE TRIAL. A PRIORI FEASIBILITY CRITERIA WERE MET REGARDING CONSENT (70%), ADHERENCE (88%), AND RETENTION (95%) RATES. CONTROLLING FOR RELEVANT COVARIATES, CHANGE SCORE ANALYSES REVEALED CLINICALLY SIGNIFICANT IMPROVEMENTS FOR PATIENTS IN THE DY COMPARED WITH THE WLC GROUP FOR OVERALL CANCER SYMPTOM SEVERITY (D = 0.96) AND SYMPTOM INTERFERENCE (D = 0.74), DEPRESSIVE SYMPTOMS (D = 0.71), AND MENTAL QOL (D = 0.69). CAREGIVERS IN THE DY GROUP REPORTED CLINICALLY SIGNIFICANT IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (D = 1.12), FATIGUE (D = 0.89), AND MENTAL QOL (D = 0.49) RELATIVE TO THOSE IN THE WLC GROUP. CONCLUSION: A DY INTERVENTION APPEARS TO BE A FEASIBLE AND BENEFICIAL SYMPTOM AND QOL MANAGEMENT STRATEGY FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS. AN EFFICACY TRIAL WITH A MORE STRINGENT CONTROL GROUP IS WARRANTED. CLINICAL TRIAL NUMBER: NCT02481349. 2019 2 199 57 A RESEARCH PROTOCOL FOR A PILOT, RANDOMIZED CONTROLLED TRIAL DESIGNED TO EXAMINE THE FEASIBILITY OF A DYADIC VERSUS INDIVIDUAL YOGA PROGRAM FOR FAMILY CAREGIVERS OF GLIOMA PATIENTS UNDERGOING RADIOTHERAPY. BACKGROUND: ALTHOUGH THE DIAGNOSIS AND TREATMENT OF A PRIMARY BRAIN TUMOR PRESENT UNIQUE CHALLENGES TO PATIENTS AND THEIR FAMILY CAREGIVERS, EVIDENCE-BASED SUPPORTIVE CARE INTERVENTIONS ARE GENERALLY LACKING. THE PRIMARY AIM OF THIS RESEARCH PROTOCOL IS TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A DYADIC YOGA (DY) VERSUS A CAREGIVER YOGA (CY) INTERVENTION OR A WAIT-LIST CONTROL (WLC) GROUP USING A RANDOMIZED CONTROLLED TRIAL DESIGN. METHODS: SEVENTY-FIVE GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS ARE RANDOMIZED TO THE DY, CY, OR A WLC GROUP. PATIENT-CAREGIVER DYADS IN THE DY GROUP AND CAREGIVERS IN THE CY GROUP RECEIVE 15 SESSIONS (45 MIN EACH) OVER THE COURSE OF PATIENTS' STANDARD RADIOTHERAPY (6 WEEKS). PATIENTS AND CAREGIVERS IN ALL GROUPS COMPLETE BASELINE ASSESSMENTS OF SYMPTOMS, QUALITY OF LIFE (QOL), AND HEALTH UTILIZATION OUTCOMES PRIOR TO RANDOMIZATION. FOLLOW-UP ASSESSMENTS ARE PERFORMED 6 WEEKS AND THEN AGAIN 3 MONTHS LATER. THE PRIMARY OUTCOME IS FEASIBILITY (I.E., >/= 50% OF ELIGIBLE DYADS CONSENT, >/= 70% OF ENROLLED DYADS COMPLETE ALL ASSESSMENTS, AND >/= 50% OF ALL PRACTICE SESSIONS ARE ATTENDED). WE WILL ALSO PERFORM PRIMARILY DESCRIPTIVE ANALYSES OF THE SELF-REPORTED OUTCOMES (E.G., FATIGUE, OVERALL QOL) AND EXPLORE POTENTIAL INTERVENTION MODERATORS (E.G., PERFORMANCE STATUS) TO INFORM A LARGER FUTURE TRIAL. CONCLUSION: THIS TRIAL WILL PROVIDE IMPORTANT INFORMATION REGARDING THE FEASIBILITY OF A DYADIC VERSUS A CAREGIVER YOGA INTERVENTION REGARDING SYMPTOM, QOL, AND HEALTH UTILIZATION OUTCOMES IN GLIOMA PATIENTS AND THEIR CAREGIVERS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02481349. 2019 3 648 84 DYADIC YOGA PROGRAM FOR PATIENTS UNDERGOING THORACIC RADIOTHERAPY AND THEIR FAMILY CAREGIVERS: RESULTS OF A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THORACIC RADIOTHERAPY (TRT) MAY RESULT IN TOXICITIES THAT ARE ASSOCIATED WITH PERFORMANCE DECLINES AND POOR QUALITY OF LIFE (QOL) FOR PATIENTS AND THEIR FAMILY CAREGIVERS. THE PURPOSE OF THIS RANDOMIZED CONTROLLED TRIAL WAS TO ESTABLISH FEASIBILITY AND PRELIMINARY EFFICACY OF A DYADIC YOGA (DY) INTERVENTION AS A SUPPORTIVE CARE STRATEGY. METHODS: PATIENTS WITH STAGE I TO III NON-SMALL CELL LUNG OR ESOPHAGEAL CANCER UNDERGOING TRT AND THEIR CAREGIVERS (N = 26 DYADS) WERE RANDOMIZED TO A 15-SESSION DY OR A WAITLIST CONTROL (WLC) GROUP. PRIOR TO TRT AND RANDOMIZATION, BOTH GROUPS COMPLETED MEASURES OF QOL (SF-36) AND DEPRESSIVE SYMPTOMS (CES-D). PATIENTS ALSO COMPLETED THE 6-MINUTE WALK TEST (6MWT). DYADS WERE REASSESSED ON THE LAST DAY OF TRT AND 3 MONTHS LATER. RESULTS: A PRIORI FEASIBILITY CRITERIA WERE MET REGARDING CONSENT (68%), ADHERENCE (80%), AND RETENTION (81%) RATES. CONTROLLING FOR RELEVANT COVARIATES, MULTILEVEL MODELING ANALYSES REVEALED SIGNIFICANT CLINICAL IMPROVEMENTS FOR PATIENTS IN THE DY GROUP COMPARED WITH THE WLC GROUP FOR THE 6MWT (MEANS: DY = 473 M VS WLC = 397 M, D = 1.19) AND SF-36 PHYSICAL FUNCTION (MEANS: DY = 38.77 VS WLC = 30.88; D = .66) AND SOCIAL FUNCTION (MEANS: DY = 45.24 VS WLC = 39.09; D = .44) ACROSS THE FOLLOW-UP PERIOD. CAREGIVERS IN THE DY GROUP REPORTED MARGINALLY CLINICALLY SIGNIFICANT IMPROVEMENTS IN SF-36 VITALITY (MEANS: DY = 53.05 VS WLC = 48.84; D = .39) AND ROLE PERFORMANCE (MEANS: DY = 52.78 VS WLC = 48.59; D = .51) RELATIVE TO THOSE IN THE WLC GROUP. CONCLUSIONS: THIS NOVEL SUPPORTIVE CARE PROGRAM APPEARS TO BE FEASIBLE AND BENEFICIAL FOR PATIENTS UNDERGOING TRT AND THEIR CAREGIVERS. A LARGER EFFICACY TRIAL WITH A MORE STRINGENT CONTROL GROUP IS WARRANTED. 2019 4 2762 75 YOGA PROGRAM FOR HIGH-GRADE GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS. BACKGROUND: DESPITE THEIR HIGH SYMPTOM BURDEN AND POOR PROGNOSIS, EVIDENCE-BASED SUPPORTIVE CARE INTERVENTIONS FOR ADULTS WITH HIGH-GRADE GLIOMA (HGG) AND THEIR CAREGIVERS ARE LACKING. THUS, WE AIMED TO ESTABLISH FEASIBILITY OF A PATIENT-CAREGIVER DYADIC YOGA PROGRAM (DYP) FOR NEWLY DIAGNOSED HGG PATIENTS AND THEIR FAMILY CAREGIVERS TARGETING QUALITY-OF-LIFE (QOL) OUTCOMES. METHOD: IN THIS SINGLE-ARM PILOT TRIAL, DYADS PARTICIPATED IN A 12-SESSION DYP PROGRAM ACROSS THE COURSE OF PATIENTS' RADIOTHERAPY. THE INTERVENTION FOCUSED ON BREATHING EXERCISES, GENTLE MOVEMENTS, AND GUIDED MEDITATIONS. WE TRACKED FEASIBILITY DATA AND ASSESSED LEVELS OF CANCER-RELATED SYMPTOMS (MD ANDERSON SYMPTOM INVENTORY [MDASI]), DEPRESSIVE SYMPTOMS (CENTERS FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION SCALE), FATIGUE (BRIEF FATIGUE INVENTORY), SLEEP DISTURBANCES (PITTSBURGH SLEEP QUALITY INDEX [PSQI]), AND OVERALL MENTAL AND PHYSICAL QOL (36-ITEM SHORT-FORM SURVEY [SF-36]) AT BASELINE AND POST-DYP, WHICH WAS AT THE END OF RADIOTHERAPY. RESULTS: WE APPROACHED 6 DYADS OF WHICH 5 DYADS (86%) CONSENTED AND COMPLETED ALL 12 SESSIONS AND PRE/POST ASSESSMENTS. ALL PATIENTS (MEAN AGE: 52 YEARS, 80% FEMALE, 80% GRADE IV) AND CAREGIVERS (MEAN AGE: 58 YEARS, 80% FEMALE, 60% SPOUSES) PERCEIVED BENEFIT FROM THE PROGRAM. PAIRED T TESTS REVEALED A MARGINALLY SIGNIFICANT, YET CLINICALLY MEANINGFUL, DECREASE IN PATIENT'S CANCER SYMPTOMS ( T = 2.32, P = .08; MDASI MEAN; PRE = 1.75, POST = 1.04). THERE WERE CLINICALLY SIGNIFICANT REDUCTIONS IN PATIENT SLEEP DISTURBANCES (PSQI MEAN: PRE = 10.75, POST = 8.00) AND IMPROVEMENTS IN PATIENT AND CAREGIVER MENTAL QOL (MCS OF SF-36 MEAN: PRE = 42.35, POST = 52.34, AND PRE = 45.14, POST = 51.43, RESPECTIVELY). CONCLUSIONS: THIS NOVEL SUPPORTIVE CARE PROGRAM APPEARS TO BE SAFE, FEASIBLE, ACCEPTABLE, AND SUBJECTIVELY USEFUL FOR HGG PATIENTS AND THEIR CAREGIVERS. THERE WAS ALSO PRELIMINARY EVIDENCE REGARDING QOL TREATMENT GAINS FOR BOTH PATIENTS AND CAREGIVERS. 2018 5 2361 57 VIVEKANANDA YOGA PROGRAM FOR PATIENTS WITH ADVANCED LUNG CANCER AND THEIR FAMILY CAREGIVERS. BACKGROUND: THE PRIMARY PURPOSE OF THIS STUDY WAS TO ESTABLISH THE FEASIBILITY OF A COUPLE-BASED VIVEKANANDA YOGA (VKC) INTERVENTION IN LUNG CANCER PATIENTS AND CAREGIVERS. SECONDLY, WE EXAMINED PRELIMINARY EFFICACY REGARDING QUALITY OF LIFE (QOL) OUTCOMES. METHOD: IN THIS SINGLE-ARM FEASIBILITY TRIAL, PATIENTS WITH LUNG CANCER UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS PARTICIPATED IN A 15-SESSION VKC PROGRAM THAT FOCUSED ON THE INTERCONNECTEDNESS OF THE DYAD. WE ASSESSED PRE-AND POST-INTERVENTION LEVELS OF FATIGUE, SLEEP DISTURBANCES, PSYCHOLOGICAL DISTRESS, OVERALL QOL, SPIRITUALITY, AND RELATIONAL CLOSENESS. WE TRACKED FEASIBILITY DATA, AND PARTICIPANTS COMPLETED PROGRAM EVALUATIONS. RESULTS: WE APPROACHED 28 ELIGIBLE DYADS OF WHICH 15 (53%) CONSENTED AND 9 (60%) COMPLETED THE INTERVENTION. PATIENTS (MEAN AGE = 73 YEARS, 63% FEMALE, ALL STAGE III) AND CAREGIVERS (MEAN AGE = 62 YEARS, 38% FEMALE, 63% SPOUSES) COMPLETED A MEAN OF 10 SESSIONS AND 95.5% OF THEM RATED THE PROGRAM AS VERY USEFUL. PAIRED T TESTS REVEALED A SIGNIFICANT INCREASE IN PATIENTS' MENTAL HEALTH (D = 0.84; P = .04) AND A SIGNIFICANT DECREASE IN CAREGIVERS' SLEEP DISTURBANCES (D = 1.44; P = .02). ALTHOUGH NOT STATISTICALLY SIGNIFICANT, FOR PATIENTS, EFFECT SIZES FOR CHANGE SCORES WERE MEDIUM FOR BENEFIT FINDING AND SMALL FOR DISTRESS (D = 0.65 AND 0.37, RESPECTIVELY). FOR CAREGIVERS, MEDIUM EFFECTS WERE FOUND FOR IMPROVEMENT IN PHYSICAL FUNCTIONING (D = 0.50). CONCLUSION: THIS NOVEL SUPPORTIVE CARE PROGRAM APPEARS TO BE SAFE, FEASIBLE, ACCEPTABLE, AND SUBJECTIVELY USEFUL FOR LUNG CANCER PATIENTS AND THEIR CAREGIVERS AND LENDS SUPPORT FOR FURTHER STUDY. 2015 6 1194 35 EXAMINING MEDIATORS AND MODERATORS OF YOGA FOR WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. HYPOTHESIS THIS STUDY EXAMINES MODERATORS AND MEDIATORS OF A YOGA INTERVENTION TARGETING QUALITY-OF-LIFE (QOL) OUTCOMES IN WOMEN WITH BREAST CANCER RECEIVING RADIOTHERAPY.METHODS WOMEN UNDERGOING 6 WEEKS OF RADIOTHERAPY WERE RANDOMIZED TO A YOGA (YG; N = 53) OR STRETCHING (ST; N = 56) INTERVENTION OR A WAITLIST CONTROL GROUP (WL; N = 54). DEPRESSIVE SYMPTOMS AND SLEEP DISTURBANCES WERE MEASURED AT BASELINE. MEDIATOR (POSTTRAUMATIC STRESS SYMPTOMS, BENEFIT FINDING, AND CORTISOL SLOPE) AND OUTCOME (36-ITEM SHORT FORM [SF]-36 MENTAL AND PHYSICAL COMPONENT SCALES [MCS AND PCS]) VARIABLES WERE ASSESSED AT BASELINE, END-OF-TREATMENT, AND 1-, 3-, AND 6-MONTHS POSTTREATMENT. RESULTS BASELINE DEPRESSIVE SYMPTOMS (P = .03) AND SLEEP DISTURBANCES (P < .01) MODERATED THE GROUP X TIME EFFECT ON MCS, BUT NOT PCS. WOMEN WITH HIGH BASELINE DEPRESSIVE SYMPTOMS IN YG REPORTED MARGINALLY HIGHER 3-MONTH MCS THAN THEIR COUNTERPARTS IN WL (P = .11). WOMEN WITH HIGH BASELINE SLEEP DISTURBANCES IN YG REPORTED HIGHER 3-MONTHS MCS THAN THEIR COUNTERPARTS IN WL (P < .01) AND HIGHER 6-MONTH MCS THAN THEIR COUNTERPARTS IN ST (P = .01). YG LED TO GREATER BENEFIT FINDING THAN ST AND WL ACROSS THE FOLLOW-UP (P = .01). THREE-MONTH BENEFIT FINDING PARTIALLY MEDIATED THE EFFECT OF YG ON 6-MONTH PCS. POSTTRAUMATIC STRESS SYMPTOMS AND CORTISOL SLOPE DID NOT MEDIATE TREATMENT EFFECT ON QOL. CONCLUSION YOGA MAY PROVIDE THE GREATEST MENTAL-HEALTH-RELATED QOL BENEFITS FOR THOSE EXPERIENCING PRE-RADIOTHERAPY SLEEP DISTURBANCE AND DEPRESSIVE SYMPTOMS. YOGA MAY IMPROVE PHYSICAL-HEALTH-RELATED QOL BY INCREASING ABILITY TO FIND BENEFIT IN THE CANCER EXPERIENCE. 2016 7 2654 36 YOGA IMPROVES QUALITY OF LIFE AND BENEFIT FINDING IN WOMEN UNDERGOING RADIOTHERAPY FOR BREAST CANCER. THIS STUDY EXAMINED THE EFFECTS OF YOGA ON QUALITY OF LIFE (QOL) AND PSYCHOSOCIAL OUTCOMES IN WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. SIXTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR A WAIT-LIST GROUP. YOGA CLASSES WERE TAUGHT BIWEEKLY DURING THE 6 WEEKS OF RADIOTHERAPY. PARTICIPANTS COMPLETED MEASURES OF QOL, FATIGUE, BENEFIT FINDING (FINDING MEANING IN THE CANCER EXPERIENCE), INTRUSIVE THOUGHTS, SLEEP DISTURBANCES, DEPRESSIVE SYMPTOMS, AND ANXIETY BEFORE RADIOTHERAPY AND THEN AGAIN 1 WEEK, 1 MONTH, AND 3 MONTHS AFTER THE END OF RADIOTHERAPY. GENERAL LINEAR MODEL ANALYSES REVEALED THAT COMPARED TO THE CONTROL GROUP, THE YOGA GROUP REPORTED SIGNIFICANTLY BETTER GENERAL HEALTH PERCEPTION (P = .005) AND PHYSICAL FUNCTIONING SCORES (P = .04) 1 WEEK POSTRADIOTHERAPY; HIGHER LEVELS OF INTRUSIVE THOUGHTS 1 MONTH POSTRADIOTHERAPY (P = .01); AND GREATER BENEFIT FINDING 3 MONTHS POSTRADIOTHERAPY (P = .01). THERE WERE NO OTHER GROUP DIFFERENCES IN OTHER QOL SUBSCALES FOR FATIGUE, DEPRESSION, OR SLEEP SCORES. EXPLORATORY ANALYSES INDICATED THAT INTRUSIVE THOUGHTS 1 MONTH AFTER RADIOTHERAPY WERE SIGNIFICANTLY POSITIVELY CORRELATED WITH BENEFIT FINDING 3 MONTHS AFTER RADIOTHERAPY (R = .36, P = .011). OUR RESULTS INDICATED THAT THE YOGA PROGRAM WAS ASSOCIATED WITH STATISTICALLY AND CLINICALLY SIGNIFICANT IMPROVEMENTS IN ASPECTS OF QOL. 2010 8 1980 34 SLEEP MODERATES THE EFFECTS OF TIBETAN YOGA FOR WOMEN WITH BREAST CANCER UNDERGOING CHEMOTHERAPY. THIS STUDY EXAMINED SELF-REPORTED AND ACTIGRAPHY-ASSESSED SLEEP AND DEPRESSION AS MODERATORS OF THE EFFECT OF A TIBETAN YOGA INTERVENTION ON SLEEP AND DEPRESSION AMONG WOMEN UNDERGOING CHEMOTHERAPY FOR BREAST CANCER. THIS IS A SECONDARY ANALYSIS OF AN RCT EXAMINING A 4-SESSION TIBETAN YOGA PROGRAM (TYP; N = 74) VERSUS STRETCHING PROGRAM (STP; N = 68) OR USUAL CARE (UC; N = 85) ON SELF-REPORTED SLEEP (PITTSBURGH SLEEP QUALITY INDEX (PSQI), ACTIGRAPHY-ASSESSED SLEEP EFFICIENCY (SE)) AND DEPRESSION (CENTERS FOR EPIDEMIOLOGICAL STUDIES DEPRESSION SCALE; CES-D) FOR WOMEN UNDERGOING CHEMOTHERAPY FOR BREAST CANCER. DATA WERE COLLECTED AT BASELINE AND 1-WEEK AND 3-MONTH POST-INTERVENTION. BASELINE PSQI, ACTIGRAPHY-SE, AND CES-D WERE EXAMINED AS MODERATORS OF THE EFFECT OF GROUP ON PSQI, ACTIGRAPHY-SE, AND CES-D 1 WEEK AND 3 MONTHS AFTER TREATMENT. THERE WAS A SIGNIFICANT BASELINE ACTIGRAPHY-SE X GROUP EFFECT ON PSQI AT 1 WEEK (P < .001) AND 3 MONTHS (P = .002) AND ON CES-D AT 3 MONTHS (P = .049). SPECIFICALLY, THE NEGATIVE ASSOCIATION OF BASELINE ACTIGRAPHY-SE WITH SUBSEQUENT PSQI AND CES-D WAS BUFFERED FOR WOMEN IN THE TYP AND, TO A LESSER EXTENT IN STP, COMPARED TO THOSE IN THE UC. BASELINE PSQI AND CES-D WERE NOT SIGNIFICANT MODERATORS OF THE EFFECT OF GROUP ON ANY OUTCOME. BEHAVIORALLY ASSESSED SLEEP MAY BE A MORE ROBUST INDICATOR OF WHICH PATIENTS ARE MOST APPROPRIATE FOR A YOGA INTERVENTION THAN SELF-REPORTED SLEEP QUALITY. WOMEN WITH POOR SLEEP EFFICIENCY MAY DERIVE THE GREATEST BENEFIT IN TERMS OF SLEEP QUALITY AND MOOD FROM A YOGA INTERVENTION. 2022 9 2360 38 VIDEOCONFERENCED YOGA INTERVENTIONS FOR CANCER PATIENTS AND THEIR CAREGIVERS DURING THE COVID-19 PANDEMIC: A REPORT FROM A CLINICIAN'S PERSPECTIVE. BACKGROUND: THE ACCEPTABILITY OF VIDEOCONFERENCING DELIVERY OF YOGA INTERVENTIONS IN THE ADVANCED CANCER SETTING IS RELATIVELY UNEXPLORED. THE CURRENT REPORT SUMMARIZES THE CHALLENGES AND SOLUTIONS OF THE TRANSITION FROM AN IN-PERSON (IE, FACE-TO-FACE) TO A VIDEOCONFERENCE INTERVENTION DELIVERY APPROACH IN RESPONSE TO THE CORONAVIRUS DISEASE PANDEMIC. METHOD: PARTICIPANTS INCLUDED PATIENT-FAMILY CAREGIVER DYADS WHO WERE ENROLLED IN ONGOING YOGA TRIALS AND 2 CERTIFIED YOGA THERAPISTS WHO DELIVERED THE YOGA SESSIONS. WE SUMMARIZED THEIR EXPERIENCES USING RECORDINGS OF THE YOGA SESSIONS AND INTERVENTIONISTS' PROGRESS NOTES. RESULTS: OUT OF 7 DYADS PARTICIPATING IN THE PARENT TRIAL, 1 DECLINED THE VIDEOCONFERENCED SESSIONS. PARTICIPANTS WERE BETWEEN THE AGES OF 55 AND 76 AND MOSTLY NON-HISPANIC WHITE (83%). PATIENTS WERE MAINLY MALE (83%), ALL HAD STAGE III OR IV CANCER AND WERE UNDERGOING RADIOTHERAPY. CAREGIVERS WERE ALL FEMALE. DESPITE CHALLENGES IN THE AREAS OF TECHNOLOGY, LOCATION, AND SETTING, INSTRUCTION AND PERSONAL CONNECTION, THE OVERALL ACCEPTABILITY WAS HIGH AMONG PATIENTS, CAREGIVERS, AND INSTRUCTORS. THROUGH THIS TRANSITION PROCESS, SOLUTIONS TO THESE CHALLENGES WERE FOUND, WHICH ARE DESCRIBED HERE. CONCLUSION: ALTHOUGH IN-PERSON INTERVENTIONS ARE FAVORED BY BOTH THE STUDY PARTICIPANTS AND THE INTERVENTIONISTS, VIDEOCONFERENCE SESSIONS WERE DEEMED ACCEPTABLE. ALL PARTICIPANTS HAD THE BENEFIT OF A PREVIOUS IN-PERSON EXPERIENCE, WHICH WAS HELPFUL AND PERHAPS NECESSARY FOR OLDER AND ADVANCED CANCER PATIENTS REQUIRING PRACTICE MODIFICATIONS. IN A REMOTE SETTING, THE ASSISTANCE OF CAREGIVERS SEEMS PARTICULARLY BENEFICIAL TO ENSURE PRACTICE SAFETY. CLINICALTRIALS.GOV: NCT03948100; NCT02481349. 2021 10 172 43 A RANDOMIZED CONTROLLED PILOT STUDY OF YOGA SKILLS TRAINING VERSUS AN ATTENTION CONTROL DELIVERED DURING CHEMOTHERAPY ADMINISTRATION. CONTEXT: IT IS IMPORTANT TO ADDRESS FATIGUE AND CO-OCCURRING SYMPTOMS DURING CHEMOTHERAPY TO PRESERVE QUALITY OF LIFE IN PATIENTS WITH GASTROINTESTINAL (GI) CANCER. OBJECTIVE: TO CONDUCT A RANDOMIZED CONTROLLED PILOT STUDY OF A YOGA SKILLS TRAINING (YST) INTERVENTION COMPARED TO AN ATTENTION CONTROL (AC) AMONG ADULTS DIAGNOSED WITH GI CANCER. METHODS: YST CONSISTED OF FOUR 30-MINUTE SESSIONS DELIVERED INDIVIDUALLY DURING CHEMOTHERAPY PLUS HOME PRACTICE. AC PROVIDED EMPATHIC ATTENTION PLUS HOME DIARIES. PATIENT-REPORTED (PROMIS T-SCORE) ASSESSMENTS OF FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND PSYCHOLOGICAL STRESS (PERCEIVED STRESS SCALE) WERE COLLECTED AT CHEMOTHERAPY VISITS: BASELINE, WEEK 8, WEEK 10 AND WEEK 14, AND ANALYZED USING A MIXED EFFECTS MODEL. INFLAMMATORY CYTOKINES WERE ASSESSED AT BASELINE AND WEEK 10. RESULTS: FORTY-FOUR OF 77 ADULTS APPROACHED AGREED TO PARTICIPATE (57%; YST N = 23; AC N = 21). PARTICIPANTS' MEAN AGE WAS 58 YEARS AND 48% WERE MEN. PARTICIPANTS RANDOMIZED TO YST REPORTED A LARGER DECLINE IN FATIGUE (-2.4 DIFFERENCE, D = 0.30) AND DEPRESSIVE SYMPTOMS (-2.5 DIFFERENCE, D = 0.30) THAN AC PARTICIPANTS FROM BASELINE TO WEEK 10 AND SLEEP DISTURBANCES AT WEEK 8 (-3.9 DIFFERENCE, D = 0.50). DIFFERENCES IN MAGNITUDE OF CHANGE IN SYMPTOMS WERE CONSISTENT WITH OR EXCEEDED A MINIMALLY IMPORTANT DIFFERENCE. PSYCHOLOGICAL STRESS DECREASED MORE IN THE AC AT WEEK 10 (D = 0.30). REDUCTIONS IN INFLAMMATORY CYTOKINES (IL-6, STNF R1) WERE LARGER IN THE YST GROUP THAN AC. CONCLUSION: YST SHOWED PROMISE FOR IMPROVING FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND INFLAMMATION. YST IS ALSO FEASIBLE AND REACHES PATIENTS UNDERREPRESENTED IN YOGA RESEARCH (I.E., GI CANCER, MEN), THUS WARRANTING FURTHER EXAMINATION. 2022 11 41 49 A BRIEF YOGA INTERVENTION IMPLEMENTED DURING CHEMOTHERAPY: A RANDOMIZED CONTROLLED PILOT STUDY. OBJECTIVES: FATIGUE AND OTHER TREATMENT-RELATED SYMPTOMS (E.G., SLEEP DISTURBANCE) ARE CRITICAL TARGETS FOR IMPROVING QUALITY OF LIFE IN PATIENTS UNDERGOING CHEMOTHERAPY. YOGA MAY REDUCE THE BURDEN OF SUCH SYMPTOMS. THIS STUDY INVESTIGATED THE FEASIBILITY OF CONDUCTING A RANDOMIZED CONTROLLED STUDY OF A BRIEF YOGA INTERVENTION DURING CHEMOTHERAPY FOR COLORECTAL CANCER. DESIGN: WE RANDOMIZED ADULTS WITH COLORECTAL CANCER TO A BRIEF YOGA SKILLS TRAINING (YST) OR AN ATTENTION CONTROL (AC; EMPATHIC ATTENTION AND RECORDED EDUCATION). SETTING: THE INTERVENTIONS AND ASSESSMENTS WERE IMPLEMENTED INDIVIDUALLY IN THE CLINIC WHILE PATIENTS WERE IN THE CHAIR RECEIVING CHEMOTHERAPY. INTERVENTIONS: BOTH INTERVENTIONS CONSISTED OF THREE SESSIONS AND RECOMMENDED HOME PRACTICE. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS FEASIBILITY (ACCRUAL, RETENTION, ADHERENCE, DATA COLLECTION). SELF-REPORTED OUTCOMES (I.E., FATIGUE, SLEEP DISTURBANCE, QUALITY OF LIFE) AND INFLAMMATORY BIOMARKERS WERE ALSO DESCRIBED TO INFORM FUTURE STUDIES. RESULTS: OF 52 PATIENTS INITIALLY IDENTIFIED, 28 WERE APPROACHED, AND 15 ENROLLED (AGE MEAN = 57.5 YEARS; 80% WHITE; 60% MALE). REASONS FOR DECLINING PARTICIPATION WERE: NOT INTERESTED (N = 6), DID NOT PERCEIVE A NEED (N = 2), AND OTHER (N = 5). TWO PARTICIPANTS WERE LOST TO FOLLOW-UP IN EACH GROUP DUE TO TREATMENT CHANGES. THUS, 75% OF PARTICIPANTS WERE RETAINED IN THE YST AND 71% IN THE AC ARM. PARTICIPANTS RETAINED IN THE STUDY ADHERED TO 97% OF THE IN-PERSON INTERVENTION SESSIONS AND COMPLETED ALL QUESTIONNAIRES. CONCLUSIONS: THIS STUDY DEMONSTRATED THE FEASIBILITY OF CONDUCTING A LARGER RANDOMIZED CONTROLLED TRIAL TO ASSESS YST AMONG PATIENTS RECEIVING CHEMOTHERAPY FOR COLORECTAL CANCER. DATA COLLECTED AND CHALLENGES ENCOUNTERED WILL INFORM FUTURE RESEARCH. 2016 12 2701 40 YOGA INTERVENTION FOR PATIENTS WITH PROSTATE CANCER UNDERGOING EXTERNAL BEAM RADIATION THERAPY: A PILOT FEASIBILITY STUDY. PURPOSE: STUDIES HAVE DEMONSTRATED BENEFICIAL HEALTH EFFECTS FROM YOGA INTERVENTIONS IN CANCER PATIENTS, BUT PREDOMINANTLY IN BREAST CANCER. RESEARCH ON ITS ROLE IN ALLEVIATING PROSTATE CANCER (PC) PATIENTS' SIDE EFFECTS HAS BEEN LACKING. OUR PRIMARY GOAL WAS TO DETERMINE THE FEASIBILITY OF RECRUITING PC PATIENTS ON A CLINICAL TRIAL OF YOGA WHILE THEY UNDERWENT EXTERNAL BEAM RADIATION THERAPY (RT). METHODS: TWICE-WEEKLY YOGA INTERVENTIONS WERE OFFERED THROUGHOUT THE RT COURSE (6-9 WEEKS). BASELINE DEMOGRAPHIC INFORMATION WAS COLLECTED. FEASIBILITY WAS DECLARED IF 15 OF THE FIRST 75 ELIGIBLE PC PATIENTS APPROACHED (20%) WERE SUCCESSFULLY ACCRUED AND COMPLETED THE INTERVENTION. ADDITIONAL END POINTS INCLUDED STANDARDIZED ASSESSMENTS OF FATIGUE, ERECTILE DYSFUNCTION (ED), URINARY INCONTINENCE (UI), AND QUALITY OF LIFE (QOL) AT TIME POINTS BEFORE, DURING, AND AFTER RT. RESULTS: BETWEEN MAY 2013 AND JUNE 2014, 68 ELIGIBLE PC PATIENTS WERE IDENTIFIED. 23 PATIENTS (34%) DECLINED, AND 45 (56%) CONSENTED TO THE STUDY. 18 (40%) WERE VOLUNTARILY WITHDRAWN DUE TO TREATMENT CONFLICTS. OF THE REMAINING 27, 12 (30%) PARTICIPATED IN >/=50% OF CLASSES, AND 15 (59%) WERE EVALUABLE. SEVERITY OF FATIGUE SCORES DEMONSTRATED SIGNIFICANT VARIABILITY, WITH FATIGUE INCREASING BY WEEK 4, BUT THEN IMPROVING OVER THE COURSE OF TREATMENT (P = .008). ED, UI, AND GENERAL QOL SCORES DEMONSTRATED REASSURINGLY STABLE, ALBEIT NOT SIGNIFICANT TRENDS. CONCLUSIONS: A STRUCTURED YOGA INTERVENTION OF TWICE-WEEKLY CLASSES IS FEASIBLE FOR PC PATIENTS DURING A 6- TO 9-WEEK COURSE OF OUTPATIENT RADIOTHERAPY. PRELIMINARY RESULTS ARE PROMISING, SHOWING STABLE MEASUREMENTS IN FATIGUE, SEXUAL HEALTH, UI, AND GENERAL QOL. 2016 13 962 36 EFFECTS OF A YOGA PROGRAM ON CORTISOL RHYTHM AND MOOD STATES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY: A RANDOMIZED CONTROLLED TRIAL. UNLABELLED: OBJECTIVES. THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY AT A CANCER CENTER. METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS ARE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO RADIOTHERAPY TREATMENT. ASSESSMENTS INCLUDE DIURNAL SALIVARY CORTISOL LEVELS 3 DAYS BEFORE AND AFTER RADIOTHERAPY AND SELF-RATINGS OF ANXIETY, DEPRESSION, AND STRESS COLLECTED BEFORE AND AFTER 6 WEEKS OF RADIOTHERAPY. RESULTS: ANALYSIS OF COVARIANCE REVEALS SIGNIFICANT DECREASES IN ANXIETY (P < .001), DEPRESSION (P = .002), PERCEIVED STRESS (P < .001), 6 A.M. SALIVARY CORTISOL (P = .009), AND POOLED MEAN CORTISOL (P = .03) IN THE YOGA GROUP COMPARED WITH CONTROLS. THERE IS A SIGNIFICANT POSITIVE CORRELATION BETWEEN MORNING SALIVARY CORTISOL LEVEL AND ANXIETY AND DEPRESSION. CONCLUSION: YOGA MIGHT HAVE A ROLE IN MANAGING SELF-REPORTED PSYCHOLOGICAL DISTRESS AND MODULATING CIRCADIAN PATTERNS OF STRESS HORMONES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY. 2009 14 2851 46 YOGA, PHYSICAL THERAPY, AND BACK PAIN EDUCATION FOR SLEEP QUALITY IN LOW-INCOME RACIALLY DIVERSE ADULTS WITH CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: POOR SLEEP IS COMMON AMONG ADULTS WITH CHRONIC LOW BACK PAIN (CLBP), BUT THE INFLUENCE OF CLBP TREATMENTS, SUCH AS YOGA AND PHYSICAL THERAPY (PT), ON SLEEP QUALITY IS UNDER STUDIED. OBJECTIVE: EVALUATE THE EFFECTIVENESS OF YOGA AND PT FOR IMPROVING SLEEP QUALITY IN ADULTS WITH CLBP. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: TWELVE WEEKLY YOGA CLASSES, 1-ON-1 PT SESSIONS, OR AN EDUCATIONAL BOOK. MAIN MEASURES: SLEEP QUALITY WAS MEASURED USING THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) GLOBAL SCORE (0-21) AT BASELINE, 12 WEEKS, AND 52 WEEKS. ADDITIONALLY, WE ALSO EVALUATED HOW THE PROPORTION OF PARTICIPANTS WHO ACHIEVED A CLINICALLY MEANINGFUL IMPROVEMENT IN SLEEP QUALITY (> 3-POINT REDUCTION IN PSQI) AT 12 WEEKS VARIED BY CHANGES IN PAIN AND PHYSICAL FUNCTION AT 6 WEEKS. KEY RESULTS: AMONG PARTICIPANTS (MEAN AGE = 46.0, 64% FEMALE, 82% NON-WHITE), NEARLY ALL (92%) REPORTED POOR SLEEP QUALITY (PSQI > 5) AT BASELINE. AT 12 WEEKS, MODEST IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED AMONG THE YOGA (PSQI MEAN DIFFERENCE [MD] = - 1.19, 95% CONFIDENCE INTERVAL [CI] - 1.82, - 0.55) AND PT (PSQI MD = - 0.91, 95% CI - 1.61, - 0.20) GROUPS. PARTICIPANTS WHO REPORTED A >/= 30% IMPROVEMENT IN PAIN OR PHYSICAL FUNCTION AT 6 WEEKS, COMPARED WITH THOSE WHO IMPROVED < 10%, WERE MORE LIKELY TO BE A SLEEP QUALITY RESPONDER AT 12 WEEKS (ODDS RATIO [OR] = 3.51, 95% CI 1.73, 7.11 AND OR = 2.16, 95% CI 1.18, 3.95, RESPECTIVELY). RESULTS WERE SIMILAR AT 52 WEEKS. CONCLUSION: IN A SAMPLE OF ADULTS WITH CLBP, VIRTUALLY ALL WITH POOR SLEEP QUALITY PRIOR TO INTERVENTION, MODEST BUT STATISTICALLY SIGNIFICANT IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED WITH BOTH YOGA AND PT. IRRESPECTIVE OF TREATMENT, CLINICALLY IMPORTANT SLEEP IMPROVEMENTS AT THE END OF THE INTERVENTION WERE ASSOCIATED WITH MID-INTERVENTION PAIN AND PHYSICAL FUNCTION IMPROVEMENTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01343927. 2020 15 1862 47 RANDOMIZED CONTROLLED TRIAL OF YOGA AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS: EFFECTS ON QUALITY OF LIFE. PURPOSE: THIS STUDY EXAMINES THE IMPACT OF YOGA, INCLUDING PHYSICAL POSES, BREATHING, AND MEDITATION EXERCISES, ON QUALITY OF LIFE (QOL), FATIGUE, DISTRESSED MOOD, AND SPIRITUAL WELL-BEING AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS. PATIENTS AND METHODS: ONE HUNDRED TWENTY-EIGHT PATIENTS (42% AFRICAN AMERICAN, 31% HISPANIC) RECRUITED FROM AN URBAN CANCER CENTER WERE RANDOMLY ASSIGNED (2:1 RATIO) TO A 12-WEEK YOGA INTERVENTION (N = 84) OR A 12-WEEK WAITLIST CONTROL GROUP (N = 44). CHANGES IN QOL (EG, FUNCTIONAL ASSESSMENT OF CANCER THERAPY) FROM BEFORE RANDOM ASSIGNMENT (T1) TO THE 3-MONTH FOLLOW-UP (T3) WERE EXAMINED; PREDICTORS OF ADHERENCE WERE ALSO ASSESSED. NEARLY HALF OF ALL PATIENTS WERE RECEIVING MEDICAL TREATMENT. RESULTS: REGRESSION ANALYSES INDICATED THAT THE CONTROL GROUP HAD A GREATER DECREASE IN SOCIAL WELL-BEING COMPARED WITH THE INTERVENTION GROUP AFTER CONTROLLING FOR BASELINE SOCIAL WELL-BEING AND COVARIATES (P < .0001). SECONDARY ANALYSES OF 71 PATIENTS NOT RECEIVING CHEMOTHERAPY DURING THE INTERVENTION PERIOD INDICATED FAVORABLE OUTCOMES FOR THE INTERVENTION GROUP COMPARED WITH THE CONTROL GROUP IN OVERALL QOL (P < .008), EMOTIONAL WELL-BEING (P < .015), SOCIAL WELL-BEING (P < .004), SPIRITUAL WELL-BEING (P < .009), AND DISTRESSED MOOD (P < .031). SIXTY-NINE PERCENT OF INTERVENTION PARTICIPANTS ATTENDED CLASSES (MEAN NUMBER OF CLASSES ATTENDED BY ACTIVE CLASS PARTICIPANTS = 7.00 +/- 3.80), WITH LOWER ADHERENCE ASSOCIATED WITH INCREASED FATIGUE (P < .001), RADIOTHERAPY (P < .0001), YOUNGER AGE (P < .008), AND NO ANTIESTROGEN THERAPY (P < .02). CONCLUSION: DESPITE LIMITED ADHERENCE, THIS INTENT-TO-TREAT ANALYSIS SUGGESTS THAT YOGA IS ASSOCIATED WITH BENEFICIAL EFFECTS ON SOCIAL FUNCTIONING AMONG A MEDICALLY DIVERSE SAMPLE OF BREAST CANCER SURVIVORS. AMONG PATIENTS NOT RECEIVING CHEMOTHERAPY, YOGA APPEARS TO ENHANCE EMOTIONAL WELL-BEING AND MOOD AND MAY SERVE TO BUFFER DETERIORATION IN BOTH OVERALL AND SPECIFIC DOMAINS OF QOL. 2007 16 1866 40 RANDOMIZED TRIAL OF TIBETAN YOGA IN PATIENTS WITH BREAST CANCER UNDERGOING CHEMOTHERAPY. BACKGROUND: THE CURRENT RANDOMIZED TRIAL EXAMINED THE EFFECTS OF A TIBETAN YOGA PROGRAM (TYP) VERSUS A STRETCHING PROGRAM (STP) AND USUAL CARE (UC) ON SLEEP AND FATIGUE IN WOMEN WITH BREAST CANCER WHO WERE UNDERGOING CHEMOTHERAPY. METHODS: WOMEN WITH STAGE (AMERICAN JOINT COMMITTEE ON CANCER (AJCC) TNM) I TO III BREAST CANCER WHO WERE UNDERGOING CHEMOTHERAPY WERE RANDOMIZED TO TYP (74 WOMEN), STP (68 WOMEN), OR UC (85 WOMEN). PARTICIPANTS IN THE TYP AND STP GROUPS PARTICIPATED IN 4 SESSIONS DURING CHEMOTHERAPY, FOLLOWED BY 3 BOOSTER SESSIONS OVER THE SUBSEQUENT 6 MONTHS, AND WERE ENCOURAGED TO PRACTICE AT HOME. SELF-REPORT MEASURES OF SLEEP DISTURBANCES (PITTSBURGH SLEEP QUALITY INDEX), FATIGUE (BRIEF FATIGUE INVENTORY), AND ACTIGRAPHY WERE COLLECTED AT BASELINE; 1 WEEK AFTER TREATMENT; AND AT 3, 6, AND 12 MONTHS. RESULTS: THERE WERE NO GROUP DIFFERENCES NOTED IN TOTAL SLEEP DISTURBANCES OR FATIGUE LEVELS OVER TIME. HOWEVER, PATIENTS IN THE TYP GROUP REPORTED FEWER DAILY DISTURBANCES 1 WEEK AFTER TREATMENT COMPARED WITH THOSE IN THE STP (DIFFERENCE, -0.43; 95% CONFIDENCE INTERVAL [95% CI], -0.82 TO -0.04 [P = .03]) AND UC (DIFFERENCE, -0.41; 95% CI, -0.77 TO -0.05 [P = .02]) GROUPS. GROUP DIFFERENCES AT THE OTHER TIME POINTS WERE MAINTAINED FOR TYP VERSUS STP. ACTIGRAPHY DATA REVEALED GREATER MINUTES AWAKE AFTER SLEEP ONSET FOR PATIENTS IN THE STP GROUP 1 WEEK AFTER TREATMENT VERSUS THOSE IN THE TYP (DIFFERENCE, 15.36; 95% CI, 7.25-23.48 [P = .0003]) AND UC (DIFFERENCE, 14.48; 95% CI, 7.09-21.87 [P = .0002]) GROUPS. PATIENTS IN THE TYP GROUP WHO PRACTICED AT LEAST 2 TIMES A WEEK DURING FOLLOW-UP REPORTED BETTER PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY OUTCOMES AT 3 MONTHS AND 6 MONTHS AFTER TREATMENT COMPARED WITH THOSE WHO DID NOT AND BETTER OUTCOMES COMPARED WITH THOSE IN THE UC GROUP. CONCLUSIONS: PARTICIPATING IN TYP DURING CHEMOTHERAPY RESULTED IN MODEST SHORT-TERM BENEFITS IN SLEEP QUALITY, WITH LONG-TERM BENEFITS EMERGING OVER TIME FOR THOSE WHO PRACTICED TYP AT LEAST 2 TIMES A WEEK. CANCER 2018;124:36-45. (C) 2017 AMERICAN CANCER SOCIETY. 2018 17 1087 46 EFFECTS OF YOGA ON SYMPTOM MANAGEMENT IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY ON DISTRESSFUL SYMPTOMS IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY. MATERIALS AND METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO THEIR RADIOTHERAPY TREATMENT. INTERVENTION CONSISTED OF YOGA SESSIONS LASTING 60 MIN DAILY WHILE THE CONTROL GROUP WAS IMPARTED SUPPORTIVE THERAPY ONCE IN 10 DAYS DURING THE COURSE OF THEIR ADJUVANT RADIOTHERAPY. ASSESSMENTS INCLUDED ROTTERDAM SYMPTOM CHECK LIST AND EUROPEAN ORGANIZATION FOR RESEARCH IN THE TREATMENT OF CANCER-QUALITY OF LIFE (EORTC QOL C30) SYMPTOM SCALE. ASSESSMENTS WERE DONE AT BASELINE AND AFTER 6 WEEKS OF RADIOTHERAPY TREATMENT. RESULTS: A GLM REPEATED-MEASURES ANOVA SHOWED A SIGNIFICANT DECREASE IN PSYCHOLOGICAL DISTRESS (P = 0.01), FATIGUE (P = 0.007), INSOMNIA (P = 0.001), AND APPETITE LOSS (P = 0.002) OVER TIME IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS SIGNIFICANT IMPROVEMENT IN THE ACTIVITY LEVEL (P = 0.02) IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS A SIGNIFICANT POSITIVE CORRELATION BETWEEN PHYSICAL AND PSYCHOLOGICAL DISTRESS AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, APPETITE LOSS, AND CONSTIPATION. THERE WAS A SIGNIFICANT NEGATIVE CORRELATION BETWEEN THE ACTIVITY LEVEL AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, AND APPETITE LOSS. CONCLUSION: THE RESULTS SUGGEST BENEFICIAL EFFECTS WITH YOGA INTERVENTION IN MANAGING CANCER-AND TREATMENT-RELATED SYMPTOMS IN BREAST CANCER PATIENTS. 2009 18 74 45 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN. 2014 19 518 34 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617. 2013 20 1865 41 RANDOMIZED PILOT TRIAL OF YOGA VERSUS STRENGTHENING EXERCISES IN BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE. PURPOSE: FATIGUE IS ONE OF THE MOST COMMON AND BOTHERSOME REFRACTORY SYMPTOMS EXPERIENCED BY CANCER SURVIVORS. MINDFUL EXERCISE INTERVENTIONS SUCH AS YOGA IMPROVE CANCER-RELATED FATIGUE; HOWEVER, STUDIES OF YOGA HAVE INCLUDED HETEROGENEOUS SURVIVORSHIP POPULATIONS, AND THE EFFECT OF YOGA ON FATIGUED SURVIVORS REMAINS UNCLEAR. METHODS: WE RANDOMLY ASSIGNED 34 EARLY-STAGE BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE (>/=4 ON A LIKERT SCALE FROM 1-10) WITHIN 1 YEAR FROM DIAGNOSIS TO A 12-WEEK INTERVENTION OF HOME-BASED YOGA VERSUS STRENGTHENING EXERCISES, BOTH PRESENTED ON A DVD. THE PRIMARY ENDPOINTS WERE FEASIBILITY AND CHANGES IN FATIGUE, AS MEASURED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF). SECONDARY ENDPOINT WAS QUALITY OF LIFE, ASSESSED BY THE FUNCTIONAL ASSESSMENT OF CANCER THERAPIES-BREAST (FACT-B). RESULTS: WE INVITED 401 WOMEN TO PARTICIPATE IN THE STUDY; 78 RESPONDED, AND WE ENROLLED 34. BOTH GROUPS HAD SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN MULTIPLE DOMAINS OF THE FATIGUE AND QUALITY OF LIFE SCORES FROM BASELINE TO POST-INTERVENTION, AND THESE BENEFITS WERE MAINTAINED AT 3 MONTHS POST-INTERVENTION. HOWEVER, THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN FATIGUE OR QUALITY OF LIFE AT ANY ASSESSMENT TIME. SIMILARLY, THERE WAS NO DIFFERENCE BETWEEN GROUPS IN ADHERENCE TO THE EXERCISE INTERVENTION. CONCLUSIONS: BOTH DVD-BASED YOGA AND STRENGTHENING EXERCISES DESIGNED FOR CANCER SURVIVORS MAY BE GOOD OPTIONS TO ADDRESS FATIGUE IN BREAST CANCER SURVIVORS. BOTH HAVE REASONABLE UPTAKE, ARE CONVENIENT AND REPRODUCIBLE, AND MAY BE HELPFUL IN DECREASING FATIGUE AND IMPROVING QUALITY OF LIFE IN THE FIRST YEAR POST-DIAGNOSIS IN BREAST CANCER PATIENTS WITH CANCER-RELATED FATIGUE. 2016