1 127 137 A PILOT STUDY TO EVALUATE THE FEASIBILITY OF INDIVIDUALIZED YOGA FOR INPATIENT CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY. BACKGROUND: FATIGUE IS AN IMPORTANT PROBLEM IN PAEDIATRIC CANCER PATIENTS AND YOGA MAY BE AN EFFECTIVE INTERVENTION. THE PRIMARY OBJECTIVE WAS TO DETERMINE THE FEASIBILITY OF INDIVIDUALIZED YOGA FOR HOSPITALIZED CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY. METHODS: WE INCLUDED ENGLISH-SPEAKING CHILDREN AND ADOLESCENTS AGED 7-18 YEARS RECEIVING INTENSIVE CHEMOTHERAPY OR HAEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT). YOGA WAS CONDUCTED THREE TIMES WEEKLY FOR THREE WEEKS. THE PRIMARY OUTCOME WAS FEASIBILITY, DEFINED AS ABILITY TO DELIVER AT LEAST 60% OF PLANNED SESSIONS. SECONDARY OUTCOMES WERE PARENT-REPORTED PEDIATRIC QUALITY OF LIFE INVENTORY (PEDSQL) MULTIDIMENSIONAL FATIGUE SCALE, FATIGUE SCALE-PARENT, PEDSQL GENERIC CORE SCALES AND PEDSQL ACUTE CANCER MODULE. RESULTS: BETWEEN JANUARY AND OCTOBER 2013, 11 PATIENTS WERE ENROLLED. MEDIAN AGE WAS 14.0 (RANGE 7.7-16.4) YEARS AND 6 (55%) WERE BOYS. YOGA WAS FEASIBLE WITH 10/11 PARTICIPANTS MEETING THE THRESHOLD FOR FEASIBILITY. THE MEDIAN NUMBER OF YOGA SESSIONS WAS 9 (RANGE 3-13). NO ADVERSE EVENTS WERE ATTRIBUTED TO YOGA. MEAN+/-STANDARD DEVIATION FOR THE DAY 21 PROXY-REPORTED PEDSQL GENERAL FATIGUE SCORES WAS 55.6+/-15.5. QUALITATIVE COMMENTS SUGGESTED DESIGN CHANGES FOR FUTURE YOGA STUDIES. CONCLUSIONS: INDIVIDUALIZED YOGA IS FEASIBLE FOR INPATIENT CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY. FUTURE WORK WILL INCLUDE DEVELOPMENT AND CONDUCT OF A RANDOMIZED TRIAL FOR FATIGUE AMELIORATION. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02105389. 2015
2 446 54 CHALLENGES OF IMPLEMENTING MULTICENTER STUDIES OF YOGA FOR PEDIATRIC CANCER AND HEMATOPOIETIC STEM CELL TRANSPLANTATION RECIPIENTS. THE PRIMARY OBJECTIVE OF THIS WORK WAS TO DETERMINE THE FEASIBILITY OF A RANDOMIZED TRIAL OF INDIVIDUALIZED YOGA FOR CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY AND FOR HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) RECIPIENTS OUTSIDE OF THE PRINCIPAL COORDINATING INSTITUTION. WE EVALUATED THE FEASIBILITY OF A RANDOMIZED TRIAL OF INDIVIDUALIZED YOGA VERSUS AN IPAD CONTROL PROGRAM AT A SITE WHERE EXTERNAL YOGA INSTRUCTORS WERE HIRED AND COMPENSATED PER SESSION. SUBJECTS WERE CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY FOR HEMATOLOGICAL MALIGNANCIES AND AUTOLOGOUS OR ALLOGENEIC HSCT RECIPIENTS EXPECTED TO BE HOSPITALIZED FOR 3 WEEKS. YOGA OR IPAD CONTROL CONTACT OCCURRED DAILY FOR 21 DAYS (EXCLUDING WEEKENDS AND HOLIDAYS); FATIGUE AND QUALITY-OF-LIFE OUTCOMES WERE MEASURED AT BASELINE, DAY 10, AND DAY 21. TEN ELIGIBLE SUBJECTS WERE IDENTIFIED; SIX SUBJECTS CONSENTED AND WERE ENROLLED. THREE WERE RANDOMIZED TO THE INDIVIDUALIZED YOGA INTERVENTION AND THREE TO THE IPAD CONTROL PROGRAM. THE MEDIAN AGE OF PARTICIPANTS WAS 12 (RANGE 8-15) YEARS, AND 2 (33%) WERE BOYS. CHALLENGES PRIMARILY RELATED TO THE HIRING OF YOGA INSTRUCTORS WHO WERE NOT TRAINED IN RESEARCH METHODS. WE FOUND ISSUES WITH: (1) LOGISTICS OF HIRING, TRAINING, AND RETAINING INSTRUCTORS; (2) COMMUNICATION BETWEEN TEAMS; (3) FIDELITY TO THE PROTOCOL AND OUTCOME ASSESSMENTS; AND (4) ENSURING SAFETY. WE FOUND THAT A RANDOMIZED TRIAL OF INDIVIDUALIZED YOGA PRESENTED NEW CHALLENGES WHEN RELYING ON EXTERNALLY CONTRACTED YOGA INSTRUCTORS. FUTURE MULTICENTER STUDIES OF YOGA SHOULD SEEK TO BETTER INTEGRATE PRACTITIONERS WITHIN THE RESEARCH TEAM TO IMPROVE PROCESSES, COMMUNICATION, FIDELITY TO THE PROTOCOL, AND SAFETY. 2021
3 615 45 DEVELOPMENT OF AN INDIVIDUALIZED YOGA INTERVENTION TO ADDRESS FATIGUE IN HOSPITALIZED CHILDREN UNDERGOING INTENSIVE CHEMOTHERAPY. PURPOSE FATIGUE IS AN IMPORTANT PROBLEM IN CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY AND HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT). EXERCISE MAY BE AN EFFECTIVE INTERVENTION FOR FATIGUE. INDIVIDUALIZED YOGA REPRESENTS AN IDEAL INTERVENTION BECAUSE IT CAN BE TAILORED ACCORDING TO AN INDIVIDUAL CHILD'S NEEDS. LITTLE IS KNOWN ABOUT HOW TO STRUCTURE A STANDARDIZED YOGA PROGRAM FOR INTENSIVELYTREATED CHILDREN. THEREFORE, THIS STUDY DESCRIBES THE DEVELOPMENT OF A YOGA PROGRAM AND AN APPROACH TO MONITORING SESSIONS SUITABLE FOR HOSPITALIZED CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY OR HSCT. METHODS THE YOGA PROGRAM WAS DESIGNED TO INCREASE MOBILITY IN HOSPITALIZED CHILDREN AND TO PROVIDE CHILDREN WITH RELAXATION TECHNIQUES THAT COULD BE USED INDEPENDENTLY IN A VARIETY OF ENVIRONMENTS. THE PROGRAM WAS FOUNDED ON 4 KEY TENETS: SAFETY, ADAPTABILITY, ENVIRONMENTAL FLEXIBILITY, AND APPEAL TO CHILDREN. WE ALSO DEVELOPED QUALITY AND CONSISTENCY ASSURANCE PROCEDURES. RESULTS A MENU FORMAT WITH A FIXED STRUCTURE WAS SELECTED FOR THE YOGA PROGRAM. EACH YOGA SESSION CONTAINED UP TO 6 SECTIONS: BREATHING EXERCISES, WARMUP EXERCISES, YOGA POSES, BALANCING POSES, COOL-DOWN POSES, AND FINAL RELAXATION. YOGA INSTRUCTORS SELECTED SPECIFIC YOGA POSES FOR EACH SESSION FROM A PREDETERMINED LIST ORGANIZED BY INTENSITY LEVEL (LOW, MODERATE, OR HIGH). MONITORING PROCEDURES WERE DEVELOPED USING VIDEOTAPING AND MULTIRATER ADJUDICATION. CONCLUSION WE CREATED A STANDARDIZED YOGA PROGRAM AND AN APPROACH TO MONITORING THAT ARE NOW READY FOR INCORPORATION IN CLINICAL TRIALS. FUTURE WORK SHOULD INCLUDE THE ADAPTATION OF THE PROGRAM TO DIFFERENT PEDIATRIC POPULATIONS AND CLINICAL SETTINGS. 2016
4 2550 38 YOGA FOR CANCER-RELATED FATIGUE IN SURVIVORS OF HEMATOPOIETIC CELL TRANSPLANTATION: A FEASIBILITY STUDY. CONTEXT: CANCER-RELATED FATIGUE (CRF) IS ONE OF THE MOST COMMON SYMPTOMS EXPERIENCED BY CANCER PATIENTS AFTER HEMATOPOIETIC CELL TRANSPLANTATION (HCT). YOGA IS AN APPROACH WITH SUPPORTIVE EVIDENCE TO IMPROVE CRF IN DIFFERENT CANCER POPULATIONS, BUT TO OUR KNOWLEDGE, IT HAS NOT BEEN TESTED IN AN ADULT HCT POPULATION. OBJECTIVES: THE AIM OF THIS STUDY WAS TO EVALUATE THE FEASIBILITY OF A YOGA INTERVENTION OFFERED TO ADULT HCT SURVIVORS WITH MODERATE-TO-SEVERE CRF. METHODS: THIS FEASIBILITY STUDY USED A SINGLE-ARM, PRETEST-POSTTEST DESIGN. ADULT HCT SURVIVORS WERE ENROLLED IN A SIX-WEEK RESTORATIVE YOGA INTERVENTION THAT CONSISTED OF A ONE-HOUR ONCE-WEEKLY CLASS WITH TWICE-WEEKLY HOME PRACTICE USING A DVD. RESULTS: TWENTY PARTICIPANTS (13 WOMEN AND SEVEN MEN) ENROLLED IN THIS STUDY WITH A MEAN AGE OF 51 YEARS (SD = 12.5). THE SAMPLE CONSISTED OF 19 ALLOGENEIC HCT SURVIVORS, SEVEN OF WHOM HAD A HISTORY OF ACUTE GRAFT-VS.-HOST DISEASE (GVHD), SIX WITH ACTIVE, EXTENSIVE CHRONIC GVHD, AND ONE AUTOLOGOUS HCT SURVIVOR. THE ACCRUAL ACCEPTANCE RATE WAS 23.2% (20/86 HCT SURVIVORS) AND RETENTION RATE WAS 60% (12/20). OVERALL ADHERENCE WAS 45.4%. NO ADVERSE EVENTS WERE REPORTED. CONCLUSION: THE RESULTS OF THIS STUDY SUGGEST THAT A RESTORATIVE YOGA INTERVENTION IN ADULT HCT SURVIVORS IS SAFE AND FEASIBLE. THE INCIDENCE OF GVHD MAY HAVE IMPACTED ADHERENCE. STRATEGIES TO IMPROVE ACCRUAL ACCEPTANCE, RETENTION, AND ADHERENCE ARE NEEDED. 2020
5 70 62 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
6 551 35 CONVENIENT AND LIVE MOVEMENT (CALM) FOR WOMEN UNDERGOING BREAST CANCER TREATMENT: CHALLENGES AND RECOMMENDATIONS FOR INTERNET-BASED YOGA RESEARCH. OBJECTIVE: TO CONDUCT A PILOT TRIAL OF INTERNET-BASED, CANCER-ADAPTED YOGA FOR WOMEN RECEIVING BREAST CANCER TREATMENT. DESIGN: WOMEN UNDERGOING RADIATION OR CHEMOTHERAPY FOR BREAST CANCER WERE RECRUITED FOR 12, 75-MIN, BIWEEKLY, CANCER-ADAPTED YOGA CLASSES DELIVERED VIA INTERNET-BASED, MULTIPOINT VIDEOCONFERENCING. DATA WERE COLLECTED ON FEASIBILITY AND ACCEPTABILITY, INCLUDING QUALITATIVE FEEDBACK FROM PARTICIPANTS AND THE YOGA INSTRUCTOR. RESULTS: AMONG 42 WOMEN APPROACHED, 13 DECLINED ELIGIBILITY SCREENING, AND 23 WERE INELIGIBLE. ALL 6 WOMEN WHO WERE ELIGIBLE PROVIDED CONSENT, BUT 2 WITHDREW PRIOR TO BEGINNING YOGA CLASSES. THE REMAINING 4 PARTICIPANTS ATTENDED 1-11 OF 12 ONLINE YOGA CLASSES. IN POST-INTERVENTION INTERVIEWS, PARTICIPANTS AND THE INSTRUCTOR AGREED THAT INTERNET-BASED YOGA CLASSES HOLD GREAT POTENTIAL FOR INCREASING ACCESS AND IMPROVING PSYCHOLOGICAL OUTCOMES IN ADULTS WITH CANCER. QUALITATIVE FEEDBACK FROM PARTICIPANTS REVEALED SUGGESTIONS FOR FUTURE TRIALS OF INTERNET-BASED, CANCER-ADAPTED YOGA CLASSES, INCLUDING: CONTINUED USE OF GROUP FORMAT; OFFERING MORE VARIED CLASS TIMES TO ACCOMMODATE PATIENTS' DEMANDING SCHEDULES AND FLUCTUATING SYMPTOMS; ENROLLING PATIENTS AFTER THEY HAVE ACCLIMATED TO OR COMPLETED CANCER TREATMENT; STREAMLINING THE TECHNOLOGY INTERFACE; AND CAREFUL ATTENTION TO PARTICIPANT BURDEN WHEN DESIGNING SURVEYS/FORMS. THE INSTRUCTOR RECOMMENDED CLOSED SESSION COURSES, AS OPPOSED TO ROLLING ENROLLMENT; TEACHING THE SAME MODIFIED POSES FOR ALL PARTICIPANTS, RATHER THAN INDIVIDUAL TAILORING; AND USING A LARGE SCREEN TO ALLOW CLOSER MONITORING OF STUDENTS' CLASS EXPERIENCE. CONCLUSIONS: INTERNET DELIVERY MAY INCREASE PATIENTS' ACCESS TO CANCER-ADAPTED YOGA CLASSES, BUT CANCER-RELATED AND TECHNOLOGICAL BARRIERS REMAIN. THIS STUDY INFORMS HOW TO OPTIMALLY DESIGN YOGA CLASSES, TECHNOLOGY, AND RESEARCH PROCEDURES TO MAXIMIZE FEASIBILITY AND ACCEPTABILITY IN FUTURE TRIALS. 2018
7 1872 20 RAPID CONVERSION OF A GROUP-BASED YOGA TRIAL FOR DIVERSE OLDER WOMEN TO HOME-BASED TELEHEALTH: LESSONS LEARNED USING ZOOM TO DELIVER MOVEMENT-BASED INTERVENTIONS. THIS BRIEF REPORT DESCRIBES THE RAPID CONVERSION OF A RANDOMIZED TRIAL OF A HATHA-BASED YOGA PROGRAM FOR OLDER WOMEN WITH URINARY INCONTINENCE TO A TELEHEALTH VIDEOCONFERENCE PLATFORM DURING THE CORONAVIRUS DISEASE 2019 (COVID-19) PANDEMIC. INTERIM RESULTS DEMONSTRATE THE FEASIBILITY OF RECRUITING AND RETAINING PARTICIPANTS ACROSS A WIDE RANGE OF AGES AND ETHNIC BACKGROUNDS, BUT ALSO POINT TO POTENTIAL OBSTACLES AND SAFETY CONCERNS ARISING FROM TELEHEALTH-BASED INSTRUCTION. THE INVESTIGATORS PRESENT LESSONS LEARNED ABOUT THE BENEFITS AND CHALLENGES OF USING TELEHEALTH PLATFORMS TO DELIVER MOVEMENT-BASED INTERVENTIONS AND CONSIDER STRATEGIES TO PROMOTE ACCESSIBLE AND WELL-TOLERATED TELEHEALTH-BASED YOGA PROGRAMS FOR OLDER AND DIVERSE POPULATIONS. CLINICAL TRIAL REGISTRATION NUMBER: NCT03672461. 2022
8 1495 37 INTERVENTION PROTOCOL FOR INVESTIGATING YOGA IMPLEMENTED DURING CHEMOTHERAPY. OBJECTIVE: FATIGUE AND OTHER TREATMENT-RELATED SYMPTOMS ARE CRITICAL THERAPEUTIC TARGETS FOR IMPROVING QUALITY OF LIFE IN PATIENTS WITH COLORECTAL CANCER DURING CHEMOTHERAPY. YOGA IS A PROMISING INTERVENTION FOR IMPROVING THESE THERAPEUTIC TARGETS AND HAS BEEN PRIMARILY INVESTIGATED IN THE GROUP-CLASS FORMAT, WHICH IS LESS FEASIBLE FOR CANCER PATIENTS WITH HIGH SYMPTOM BURDEN TO ATTEND. THUS, WE DEVELOPED A PROTOCOL FOR IMPLEMENTING YOGA INDIVIDUALLY IN THE CLINIC AMONG PATIENTS RECEIVING CHEMOTHERAPY. METHODS: WE FOLLOWED RECOMMENDED DOMAINS FOR DEVELOPING A YOGA PROTOCOL TO BE USED IN AN EFFICACY TRIAL. THESE RECOMMENDATIONS INCLUDE CONSIDERATION TO THE STYLE, DELIVERY, COMPONENTS OF THE INTERVENTION, DOSE, SPECIFIC CLASS SEQUENCES, FACILITATION OF HOME PRACTICE, MEASUREMENT OF INTERVENTION FIDELITY, SELECTION OF INSTRUCTORS, AND DEALING WITH MODIFICATIONS. THE INTERVENTION PROTOCOL WAS DEVELOPED BY AN INTERDISCIPLINARY TEAM. PROTOCOL: YOGA SKILLS TRAINING (YST) CONSISTS OF FOUR 30-MINUTE IN-PERSON SESSIONS AND WAS IMPLEMENTED WHILE IN THE CHAIR DURING CHEMOTHERAPY INFUSIONS FOR COLORECTAL CANCER WITH RECOMMENDED DAILY HOME PRACTICE FOR EIGHT WEEKS. THERAPEUTIC GOALS OF THE YST ARE TO REDUCE FATIGUE, CIRCADIAN DISRUPTION, AND PSYCHOLOGICAL DISTRESS. ELEMENTS OF THE YST ARE AWARENESS MEDITATION, GENTLE SEATED MOVEMENT, BREATHING PRACTICE, AND RELAXATION MEDITATION. ATTENTION, COMFORT, AND EASE ARE ALSO HIGHLIGHTED. CONCLUSION: THIS DESCRIPTION OF A PROTOCOL FOR INTEGRATING YOGA WITH CONVENTIONAL CANCER TREATMENT WILL INFORM FUTURE STUDY DESIGNS AND CLINICAL PRACTICE. THE DESIGN OF THE YST IS NOVEL BECAUSE IT IMPLEMENTS YOGA-MOST COMMONLY STUDIED WHEN TAUGHT TO GROUPS OUTSIDE OF THE CLINICAL SETTING- INDIVIDUALLY DURING CLINICAL CARE. 2016
9 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
10 900 39 EFFECTIVENESS AND COST-EFFECTIVENESS OF A YOGA-BASED CARDIAC REHABILITATION (YOGA-CARE) PROGRAM FOLLOWING ACUTE MYOCARDIAL INFARCTION: STUDY RATIONALE AND DESIGN OF A MULTI-CENTER RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CARDIAC REHABILITATION (CR) IS A STANDARD TREATMENT FOR SECONDARY PREVENTION OF ACUTE MYOCARDIAL INFARCTION (AMI) IN HIGH INCOME COUNTRIES (HICS), BUT IT IS INACCESSIBLE TO MOST PATIENTS IN INDIA DUE TO HIGH COSTS AND SKILLS REQUIRED FOR MULTIDISCIPLINARY CR TEAMS. WE DEVELOPED A LOW-COST AND SCALABLE CR PROGRAM BASED ON CULTURALLY-ACCEPTABLE PRACTICE OF YOGA (YOGA-CARE). IN THIS PAPER, WE REPORT THE RATIONALE AND DESIGN FOR EVALUATION OF ITS EFFECTIVENESS AND COST-EFFECTIVENESS. METHODS: THIS IS A MULTI-CENTER, SINGLE-BLIND, TWO-ARM PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL ACROSS 22 CARDIAC CARE HOSPITALS IN INDIA. FOUR THOUSAND PATIENTS AGED 18-80YEARS WITH AMI WILL BE RECRUITED AND RANDOMIZED 1:1 TO RECEIVE YOGA-CARE PROGRAM (13 SESSIONS SUPERVISED BY AN INSTRUCTOR AND ENCOURAGEMENT TO SELF-PRACTICE DAILY) OR ENHANCED STANDARD CARE (3 SESSIONS OF HEALTH EDUCATION) DELIVERED OVER A PERIOD OF THREE MONTHS. PARTICIPANTS WILL BE FOLLOWED 3-MONTHLY TILL THE END OF THE TRIAL. THE CO-PRIMARY OUTCOMES ARE A) TIME TO OCCURRENCE OF FIRST CARDIOVASCULAR EVENT (COMPOSITE OF ALL-CAUSE MORTALITY, NON-FATAL MYOCARDIAL INFARCTION, NON-FATAL STROKE AND EMERGENCY CARDIOVASCULAR HOSPITALIZATION), AND B) QUALITY OF LIFE (EURO-QOL-5L) AT 12WEEKS. SECONDARY OUTCOMES INCLUDE NEED FOR REVASCULARIZATION PROCEDURES, RETURN TO PRE-INFARCT ACTIVITIES, TOBACCO CESSATION, MEDICATION ADHERENCE, AND COST-EFFECTIVENESS OF THE INTERVENTION. CONCLUSION: THIS TRIAL WILL ALONE CONTRIBUTE >20% PARTICIPANTS TO EXISTING META-ANALYSES OF RANDOMIZED TRIALS OF CR WORLDWIDE. IF YOGA-CARE IS FOUND TO BE EFFECTIVE, IT HAS THE POTENTIAL TO SAVE MILLIONS OF LIVES AND TRANSFORM CARE OF AMI PATIENTS IN INDIA AND OTHER LOW AND MIDDLE INCOME COUNTRY SETTINGS. 2019
11 491 22 CO-DESIGNING A NEW YOGA-BASED MINDFULNESS INTERVENTION FOR SURVIVORS OF STROKE: A FORMATIVE EVALUATION. MOVEMENT-BASED MINDFULNESS INTERVENTIONS (MBI) ARE COMPLEX, MULTI-COMPONENT INTERVENTIONS FOR WHICH THE DESIGN PROCESS IS RARELY REPORTED. FOR PEOPLE WITH STROKE, EMERGING EVIDENCE SUGGESTS BENEFITS, BUT MAINSTREAM PROGRAMS ARE GENERALLY UNSUITABLE. WE AIMED TO DESCRIBE THE PROCESSES INVOLVED AND TO CONDUCT A FORMATIVE EVALUATION OF THE DEVELOPMENT OF A NOVEL YOGA-BASED MBI DESIGNED FOR SURVIVORS OF STROKE. WE USED THE MEDICAL RESEARCH COUNCIL COMPLEX INTERVENTIONS FRAMEWORK AND PRINCIPLES OF CO-DESIGN. WE PURPOSEFULLY APPROACHED HEALTH PROFESSIONALS AND CONSUMERS TO ESTABLISH AN ADVISORY COMMITTEE FOR DEVELOPING THE INTERVENTION. MEMBERS COLLABORATED AND ITERATIVELY REVIEWED THE DESIGN AND CONTENT OF THE PROGRAM, FORMATTED INTO A TRAINING MANUAL. FOUR EXTERNAL YOGA TEACHERS INDEPENDENTLY REVIEWED THE PROGRAM. FORMATIVE EVALUATION INCLUDED REVIEW OF MULTIPLE DATA SOURCES AND DOCUMENTATION (E.G., FORMAL MEETING MINUTES, FOCUS GROUP DISCUSSIONS, RESEARCHER OBSERVATIONS). THE DATA WERE SYNTHESIZED USING INDUCTIVE THEMATIC ANALYSIS. THREE BROAD THEMES EMERGED: (A) MBI CONTENT AND TERMINOLOGY; (B) MANUAL DESIGN AND READABILITY; AND (C) BARRIERS AND ENABLERS TO DELIVER THE INTERVENTION. VARIOUS PERSPECTIVES AND FEEDBACK ON ESSENTIAL COMPONENTS GUIDED FINALIZING THE PROGRAM. THE DESIGN PHASE OF A NOVEL YOGA-BASED MBI WAS STRENGTHENED BY INTERDISCIPLINARY, CONSUMER CONTRIBUTIONS AND PEER REVIEW. THE 12-WEEK INTERVENTION IS READY FOR TESTING AMONG SURVIVORS OF STROKE. 2021
12 1773 22 POTENTIAL YOGA MODULES FOR TREATMENT OF HEMATOPOIETIC INHIBITION IN HIV-1 INFECTION. THIS ARTICLE IS EXPECTED TO CONTRIBUTE TOWARDS UNDERSTANDING THE THERAPEUTIC BENEFITS OF SPECIFIC YOGA MODULES ON THE INHIBITION OF REPLICATION AND ENHANCEMENT TO NORMAL LEVELS OF HEMATOPOIESIS IN HIV-1 INFECTED SUBJECTS. MORE UNIQUE COULD BE THE EFFECTS OF YOGA ON THE INDIRECT EFFECTS OF HIV-1 INDUCED HEMATOPOIETIC INHIBITION OF THE CD34+ PROGENITOR STEM CELLS, VIA THE CD4+ T LYMPHOCYTES. SUCH INDIRECT EFFECTS MAY BE CAUSED BY HOST CELLULAR FACTORS. YOGA PRACTICES MAY ALSO IMPROVE THE SELF RENEWAL CAPACITY (A STEP THAT PRECEDES COMMITMENT OF CD34+ PROGENITOR CELLS TO TERMINAL DIFFERENTIATION), VIA STAT5 GENE REGULATION. THIS MAY ELIMINATE THE NEED FOR CONSTITUTIVE STAT5 GENE EXPRESSION THROUGH GENE THERAPY. IN THIS ARTICLE RECENT RESEARCH AND ANCIENT INDIAN LITERATURE ARE REVIEWED TO DEVISE YOGA MODULES FOR THE POTENTIAL TREATMENT OF HEMATOPOIETIC INHIBITION IN HIV-1 INFECTION. THE POSSIBLE MECHANISMS THROUGH WHICH HEMATOPOIETIC INHIBITION MAY OCCUR IN HIV-1 INFECTED PATIENTS ARE FIRST DESCRIBED FOLLOWED BY THE ROLE OF STRESS IN THE PROGRESSION OF HIV WHERE PROBABLE INVOLVEMENT OF PSYCHO-NEURO-IMMUNOLOGICAL AXIS (PNI) IS HIGHLIGHTED. YOGA THERAPY IS INTRODUCED AND ITS EFFECTIVENESS IN TERMS OF EVIDENCE IN RELEVANT AREA IS REVIEWED. FURTHER, THE BASIC PRINCIPLES OF INTEGRATED APPROACH OF YOGA THERAPY [IAYT] ARE DESCRIBED AND DEPENDING ON THE POTENTIAL MECHANISMS THROUGH WHICH YOGA THERAPY MAY ACT, BOTH MODERN SCIENTIFIC RESEARCH AND ANCIENT "SCRIPTURAL" EVIDENCE ARE PROVIDED AT ALL THE FIVE LEVELS OF EXISTENCE (BODY, LIFE FORCE, EMOTIONAL, INTELLECTUAL AND BLISS). THIS WILL ENABLE TO DESIGN COMPREHENSIVE YOGA MODULES THAT MAY INTERVENE IN THIS INDIRECT INHIBITION OF HAEMATOPOIESIS IN HIV-1 INFECTED INDIVIDUALS AND POTENTIALLY RESTORE NORMAL LEVELS OF HAEMATOPOIESIS. 2010
13 1250 31 FEASIBILITY STUDY: THE EFFECT OF THERAPEUTIC YOGA ON QUALITY OF LIFE IN CHILDREN HOSPITALIZED WITH CANCER. PURPOSE: TO DESCRIBE THE EFFECT OF THERAPEUTIC YOGA ON CHILD AND PARENTAL REPORTS OF QUALITY OF LIFE IN CHILDREN HOSPITALIZED WITH ONCOLOGICAL DIAGNOSES. METHODS: SIX CHILDREN PARTICIPATED IN 5 YOGA SESSIONS OVER 2 MONTHS. THE PEDSQL 4.0 WAS ADMINISTERED TO EACH CHILD AND PARTICIPATING PARENT/CAREGIVERS AT BASELINE AND AFTER COMPLETION OF THE YOGA INTERVENTION. THE WILCOXON NONPARAMETRIC RANK TEST MEASURED INDIVIDUAL DIFFERENCES OVER TIME. RESULTS: STATISTICALLY SIGNIFICANT DIFFERENCES (P < .05) WERE FOUND IN CHILD PERCEPTION OF GROSS MOTOR FUNCTION. CONCLUSION: THESE FEASIBILITY STUDY DATA SUGGEST THAT THERAPEUTIC YOGA POSITIVELY AFFECTED CHILD PERCEPTION OF GROSS MOTOR FUNCTION MEASURED ON THE PEDSQL 4.0. FURTHER STUDIES ARE NEEDED, INCLUDING A RANDOMIZED CONTROL TRIAL AND WITH A LARGER NUMBER OF PARTICIPANTS, TO CLARIFY AND CONFIRM THE EFFECT OF THERAPEUTIC YOGA. 2011
14 2360 29 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
15 1331 45 HOME-BASED YOGA PROGRAM FOR THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA DURING CHEMOTHERAPY: A FEASIBILITY STUDY. BACKGROUND: YOGA IS PROVEN BENEFICIAL IN IMPROVING QUALITY OF LIFE AMONG BREAST CANCER SURVIVORS RECEIVING CHEMOTHERAPY, BUT ITS EFFECTIVENESS IN LYMPHOMA PATIENTS NEEDS TO BE EXPLORED. AS CHEMOTHERAPY-INDUCED NEUTROPENIA IS VERY COMMON AMONG LYMPHOMA PATIENTS, THEY ARE MUCH PRONE TO INFECTIONS FROM THE ENVIRONMENT. FURTHERMORE, TRAINED YOGA INSTRUCTORS ARE NOT AVAILABLE IN EVERY SETTING, SO THERE IS A NEED TO DEVELOP HOME-BASED YOGA PROGRAM MODULES FOR LYMPHOMA PATIENTS RECEIVING CHEMOTHERAPY. AIM: THE AIM OF THE STUDY WAS TO EXPLORE THE FEASIBILITY AND SAFETY OF YOGIC EXERCISES AMONG LYMPHOMA PATIENTS DURING CHEMOTHERAPY. SUBJECTS AND METHODS: AN INTERVENTIONAL, SINGLE-ARM PREPOST DESIGN STUDY WAS CONDUCTED AT A TERTIARY HEALTH-CARE CENTER. PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA (18-65 YEARS) WITH EASTERN COOPERATIVE ONCOLOGY GROUP PERFORMANCE STATUS FROM 0 TO 2, PLANNED TO RECEIVE CHEMOTHERAPY WERE ADMINISTERED A HOME-BASED YOGA PROGRAM OVER A PERIOD OF 2 MONTHS FROM THE START OF CHEMOTHERAPY. THE PRIMARY OUTCOME VARIABLES WERE RETENTION RATE, ACCEPTANCE RATE, SAFETY, AND ADHERENCE. HEALTH-RELATED QUALITY OF LIFE (HRQOL), FATIGUE LEVEL, OVERALL SLEEP QUALITY, DEPRESSION, ANXIETY LEVEL, AND PAIN WERE ALSO ASSESSED. STATISTICAL ANALYSIS: DESCRIPTIVE STATISTICS WAS USED TO SEE THE FEASIBILITY AND ADHERENCE. THE PAIRED T-TEST WAS USED TO COMPARE VARIOUS PRE AND POSTINTERVENTION OUTCOME MEASURES. RESULTS: FOURTEEN PATIENTS (MEDIAN AGE: 36 YEARS, RANGE13-65 YEARS) OF MALIGNANT LYMPHOMA WERE ENROLLED IN THE STUDY. MALE-TO-FEMALE RATIO WAS 9:5. NON-HODGKIN'S LYMPHOMA PATIENTS CONSTITUTED 64%. THE RECRUITMENT RATE WAS 93%. FAVORABLE RETENTION (100%), ACCEPTABILITY (97%), ADHERENCE (78.6%), AND NO SERIOUS ADVERSE EVENTS FOLLOWING YOGA PRACTICE WERE REPORTED. IMPROVEMENT WAS ALSO FOUND IN HRQOL, FATIGUE, SLEEP, DEPRESSION, AND ANXIETY. HOWEVER, IT NEEDS FURTHER VALIDATION IN A RANDOMIZED STUDY. CONCLUSION: HOME-BASED YOGA PROGRAM IS SAFE AND FEASIBLE AMONG THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA RECEIVING CHEMOTHERAPY. 2018
16 1447 41 INDIVIDUALIZED, SINGLE SESSION YOGA THERAPY TO REDUCE PHYSICAL AND EMOTIONAL SYMPTOMS IN HOSPITALIZED HEMATOLOGICAL CANCER PATIENTS. OBJECTIVE: INPATIENT TREATMENT OF HEMATOLOGICAL CANCER IS AMONG THE MOST PHYSICALLY AND MENTALLY ARDUOUS CANCER TREATMENTS, AND IT IS ASSOCIATED WITH A NUMBER OF COMMON PHYSICAL, EMOTIONAL, AND SOCIAL SYMPTOMS THAT CAN NEGATIVELY AFFECT QUALITY OF LIFE (QOL) FOR YEARS FOLLOWING TREATMENT. WHILE TREATING SYMPTOMS DURING HOSPITALIZATION HOLDS PROMISE FOR IMPROVING LONG-TERM QOL, SUCCESSFUL APPROACHES LIKELY REQUIRE MULTIDISCIPLINARY INTERVENTIONS. IN THIS ARTICLE, WE DESCRIBE A 4-YEAR EFFORT IN PROGRAM ENHANCEMENT THAT INCORPORATED AN ADJUNCTIVE SINGLE YOGA THERAPY SESSION DURING TREATMENT FOR HEMATOLOGICAL MALIGNANCIES. METHODS: HOSPITALIZED PATIENTS RECEIVING TREATMENT FOR HEMATOLOGICAL CANCER (N = 486) WERE PROVIDED A 40-MINUTE INDIVIDUALIZED YOGA THERAPY SESSION. WE EVALUATED FEASIBILITY AND ACCEPTANCE BY QUANTIFYING THE PERCENTAGE OF PATIENTS WHO DISCONTINUED THE YOGA SESSION DUE TO PAIN, DISCOMFORT, OR ANOTHER REASON, AND BY COMPARING THE INTERVENTION POPULATION TO THE DEMOGRAPHIC MAKEUP OF THE UNIT MORE GENERALLY. PATIENT-REPORTED SYMPTOMS WERE OBTAINED BEFORE AND AFTER EACH SESSION, AND WE EVALUATED ACUTE SYMPTOM CHANGE FOR THE ENTIRE SAMPLE AND IN SUBSAMPLES THAT ARE LESS LIKELY TO USE MINDFULNESS-BASED INTERVENTIONS SUCH AS YOGA. RESULTS: THE MAJORITY OF SESSIONS (87%) WERE COMPLETED, AND THE MAJORITY OF UNFINISHED SESSIONS WERE INTERRUPTED BY A MEDICAL PROCEDURE OR BECAUSE THE PATIENT FELL ASLEEP. NO SESSION WAS STOPPED EARLY DUE TO PATIENTS' REPORTED PAIN. SIGNIFICANT DECREASES WERE REPORTED IN ALL SYMPTOMS, WITH THE GREATEST DECREASE IN FATIGUE AND ANXIETY. CONCLUSIONS: YOGA THERAPY WAS A FEASIBLE AND EFFECTIVE NONDRUG ADJUNCT INTERVENTION FOR HOSPITALIZED PATIENTS RECEIVING TREATMENT FOR HEMATOLOGICAL CANCER, INCLUDING BONE MARROW TRANSPLANTATION. 2019
17 1156 39 ENSURING YOGA INTERVENTION FIDELITY IN A RANDOMIZED PREFERENCE TRIAL FOR THE TREATMENT OF WORRY IN OLDER ADULTS. INTRODUCTION: YOGA FOR TREATMENT OF WORRY IN OLDER ADULTS IS AN INTERVENTION THAT IS ESPECIALLY LIKELY TO TRANSLATE INTO REAL-WORLD PRACTICE. ASSESSING TREATMENT FIDELITY IMPROVES CONFIDENCE THAT EFFECTIVE INTERVENTIONS CAN BE CONSISTENTLY APPLIED AND ALLOWS RESEARCHERS TO EXPLORE IF ANY NULL RESULTS FOR EFFECTIVENESS ARE INDEED THE RESULT OF A LACK OF INTERVENTION EFFICACY OR LACK OF PROPER INTERVENTION IMPLEMENTATION. METHODS: THIS STUDY DESCRIBES TREATMENT FIDELITY OF A YOGA INTERVENTION IN A RANDOMIZED PREFERENCE TRIAL THAT COMPARED COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA FOR THE TREATMENT OF WORRY, ANXIETY, AND SLEEP IN WORRIED OLDER (>/=60 YEARS) ADULTS. ESTABLISHED METHODS FOR ASSESSING TREATMENT FIDELITY OF CBT GUIDED THE PROCEDURE FOR ENSURING THAT THE YOGA INTERVENTION WAS DELIVERED AS INTENDED. THE YOGA INTERVENTION CONSISTED OF 20, 75-MIN, IN-PERSON, GROUP, GENTLE YOGA CLASSES HELD TWICE WEEKLY. RESULTS: SIX FEMALE INSTRUCTORS (MEAN AGE = 64 YEARS) TAUGHT 660 YOGA CLASSES THAT WERE VIDEOTAPED. TEN PERCENT OF THESE CLASSES, STRATIFIED BY INSTRUCTOR, WERE RANDOMLY SELECTED FOR REVIEW. THE AVERAGE ADHERENCE SCORE FOR YOGA INSTRUCTORS WAS 6.84 (RANGE 4-8). THE AVERAGE COMPETENCY SCORES WERE CONSISTENTLY HIGH, WITH AN AVERAGE SCORE OF 7.24 (RANGE 6-8). TEACHING CONTENT NOT INCLUDED IN THE PROTOCOL OCCURRED IN 26 (38.1%) SESSIONS AND DECREASED OVER TIME. OBSERVED RATINGS OF INSTRUCTOR ADHERENCE WERE SIGNIFICANTLY RELATED TO RATINGS OF COMPETENCY. INSTRUCTOR ADHERENCE WAS ALSO SIGNIFICANTLY ASSOCIATED WITH LOWER PARTICIPANT ATTENDANCE, BUT NOT WITH ANY OF THE OTHER PROCESS OR OUTCOME MEASURES. CONCLUSIONS: THE LARGER RANGE FOUND IN ADHERENCE RELATIVE TO COMPETENCE SCORES DEMONSTRATED THAT TEACHING A YOGA CLASS ACCORDING TO A PROTOCOL REQUIRES DIFFERENT SKILLS THAN COMPETENTLY TEACHING A YOGA CLASS IN THE COMMUNITY, AND THESE SKILLS IMPROVED WITH FEEDBACK. THESE RESULTS MAY FOSTER DIALOG BETWEEN THE YOGA RESEARCH AND PRACTICE COMMUNITIES. CLINICAL TRIAL REGISTRATION NO.: NCT02968238. 2021
18 1821 40 PROTOCOL FOR TESTING YOGA TO REDUCE POST-LUMBAR SPINE SURGERY PAIN: A METHODOLOGY ARTICLE. CURRENTLY, ACUTE POSTOPERATIVE PAIN DURING HOSPITALIZATION IS PRIMARILY MANAGED BY MEDICATIONS, AND PATIENTS MUST ADHERE TO RESTRICTIVE POSTOPERATIVE PRECAUTIONS FOR 3 MONTHS FOLLOWING LUMBAR SPINE SURGERIES. YOGA CAN BE AN ALTERNATIVE APPROACH TO ASSIST IN ACUTE AND SUBACUTE POSTOPERATIVE PAIN MANAGEMENT, ANXIETY, AND RETURN TO FUNCTION. THE PURPOSE OF THE PRESENT WORK WAS TO DEVELOP AND TEST THE FEASIBILITY AND EXPLORE THE EFFECTIVENESS OF A TAILORED YOGA PROGRAM, DELIVERED IN-PERSON DURING THE HOSPITAL STAY AND ELECTRONICALLY AFTER HOSPITAL DISCHARGE, AS A POTENTIAL NEW AVENUE FOR POSTOPERATIVE CARE. THIS PILOT STUDY WILL USE A CROSSOVER RANDOMIZED CONTROLLED DESIGN. INDIVIDUALS AGED BETWEEN 40 AND 80 YEARS WHO ARE SCHEDULED FOR LUMBAR LAMINECTOMY AND/OR FUSION, AND WHO HAVE NOT PRACTICED REGULAR YOGA WITHIN THE PAST 6 MONTHS AT THE TIME OF ENROLLMENT, WILL BE RECRUITED AND RANDOMIZED TO EITHER A TAILORED YOGA PROGRAM (INTERVENTION GROUP) OR USUAL CARE (CONTROL GROUP) DURING THE HOSPITAL STAY (PHASE ONE). BEARING IN MIND POSTOPERATIVE PRECAUTIONS, ALL SUBJECTS WILL BE INSTRUCTED TO PERFORM A HOME-BASED TAILORED YOGA PROGRAM DELIVERED ELECTRONICALLY VIA YOUTUBE LINKS FOR 8 WEEKS POST-HOSPITAL DISCHARGE (PHASE TWO). THE PRIMARY OUTCOME MEASURES ASSESSING FEASIBILITY ARE ADHERENCE/COMPLIANCE. SECONDARY OUTCOME MEASURES INCLUDE PAIN, ANXIETY, FUNCTION, SLEEP, PERCEIVED STRESS, AND PAIN-CATASTROPHIZING BEHAVIOR. LENGTH OF HOSPITAL STAY AND PAIN MEDICATION USE, GAIT DISTANCE, AND OVERALL PHYSICAL ACTIVITY DURING HOSPITALIZATION WILL ALSO BE COLLECTED. FINALLY, A QUALITATIVE INTERVIEW WILL BE OBTAINED AFTER COMPLETION OF THE HOSPITAL AND HOME-BASED PROGRAMS. THIS STUDY WILL DETERMINE THE FEASIBILITY OF A TAILORED YOGA PROGRAM FOR ACUTE AND SUBACUTE POSTOPERATIVE LUMBAR SPINE SURGERY PAIN, ANXIETY, AND FUNCTIONAL OUTCOMES. 2021
19 2557 45 YOGA FOR CHRONIC CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY PAIN: A PILOT, RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A YOGA INTERVENTION FOR CANCER SURVIVORS WITH CHRONIC CIPN PAIN, AS WELL AS THE IMPACT OF THE INTERVENTION ON PATIENT-REPORTED OUTCOMES. METHODS: CANCER SURVIVORS WITH CHRONIC CIPN PAIN WERE RECRUITED FROM THE BREAST, GASTROINTESTINAL, AND GYNECOLOGICAL ONCOLOGY CENTERS AT DANA-FARBER CANCER INSTITUTE. PARTICIPANTS WERE RANDOMIZED (2:1) TO RECEIVE AN 8-WEEK YOGA INTERVENTION OR USUAL CARE. AFTER 21/50 OF PARTICIPANTS WERE ENROLLED, THE COVID-19 PANDEMIC REQUIRED THE YOGA INTERVENTION TO BE DELIVERED VIRTUALLY (I.E., ZOOM). PRE- AND POST-INTERVENTION, PARTICIPANTS SELF-REPORTED CIPN AND CO-OCCURRING SYMPTOM SEVERITY. ADHERENCE TO THE INTERVENTION WAS DEFINED AS PRACTICING >/= 12 YOGA SESSIONS OVER THE 8-WEEK INTERVENTION PERIOD. CHANGES IN PATIENT-REPORTED OUTCOMES BETWEEN GROUPS WERE COMPARED USING WILCOXON'S RANK-SUM TESTS. RESULTS: PARTICIPANTS (N = 28 YOGA, N = 16 CONTROL) WERE MAINLY FEMALE (96%) AND DIAGNOSED WITH STAGE III/IV DISEASE (66%). OVERALL, 19/28 (67.8%) OF YOGA GROUP PARTICIPANTS WERE ADHERENT TO THE YOGA PROTOCOL. YOGA GROUP PARTICIPANTS EXPERIENCED SIGNIFICANT WITHIN-GROUP IMPROVEMENTS IN ALL PATIENT-REPORTED OUTCOMES, INCLUDING WORST CIPN PAIN (MEDIAN CHANGE = - 1.7, P < 0.0001) AND SENSORY CIPN (MEDIAN CHANGE = - 14.8, P < 0.0001), BUT ONLY IMPROVEMENTS IN FATIGUE (P = 0.05) AND DEPRESSION (P = 0.04) WERE SIGNIFICANT COMPARED TO THE CONTROL. THERE WERE NO DIFFERENCES (P > 0.05) IN CHANGES IN PATIENT-REPORTED OUTCOMES BETWEEN IN-PERSON (N = 6) OR VIRTUAL (N = 15) YOGA GROUP PARTICIPANTS. CONCLUSIONS: YOGA IS A FEASIBLE NON-PHARMACOLOGICAL MODALITY FOR CANCER SURVIVORS WITH CIPN, BUT MORE INFORMATION IS NEEDED REGARDING ITS IMPACT ON CIPN AND OTHER SYMPTOMS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT03824860 IMPLICATIONS FOR CANCER SURVIVORS: ONCOLOGY CLINICIANS MAY CONSIDER REFERRING CANCER SURVIVORS TO YOGA FOR CHRONIC CIPN PAIN, BUT YOGA CANNOT BE CURRENTLY RECOMMENDED AS AN EFFICACIOUS TREATMENT. 2021
20 2224 22 THE IMPACT OF THE "YOGIC LIFESTYLE" ON CANCER PROGNOSIS AND SURVIVAL: CAN WE TARGET CANCER STEM CELLS WITH YOGA? CANCER HAS RECENTLY BEEN KNOWN TO ORIGINATE FROM STEM CELL-LIKE CELLS, CALLED CANCER STEM CELLS (CSCS). THEIR UNIQUE PROPERTIES OF SELF-DUPLICATION, MULTIPLICATION, AS WELL AS MIGRATION GIVE THE CSC RESISTANCE OVER CONVENTIONAL CANCER THERAPIES. NEWER THERAPIES ARE IN DEVELOPMENTAL STAGE TO TARGET THESE STEM CELL-LIKE POPULATIONS AND BECOME THE VANGUARD OF FUTURE TREATMENTS. SEVERAL COMPLEMENTARY AND ALTERNATIVE TREATMENTS HAVE BEEN USED IN CANCER MANAGEMENT AS AN ADJUNCT TO CONVENTIONAL THERAPY TO IMPROVE THE OVERALL QUALITY OF LIFE AND REDUCE RECURRENCE. YOGA STANDS AS THE THIRD MOST POPULAR OF ALL COMPLEMENTARY AND ALTERNATIVE MEDICINE TREATMENTS CURRENTLY USED IN CANCER PATIENTS TODAY. PRELIMINARY RESULTS SHOW THAT YOGA MODULATES NEURAL, HORMONAL, AND IMMUNE FUNCTIONS AT A CELLULAR LEVEL. THE SCOPE OF THIS COMMENTARY IS TO DISCUSS THE CURRENT EVIDENCE-BASED MEDICINE ON YOGA AND ITS EFFECT ON CSCS. 2017