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 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 3 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 4 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 5 199 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 6 1746 43 PILOT EVALUATION OF AN IYENGAR YOGA PROGRAM FOR BREAST CANCER SURVIVORS. BACKGROUND: WITH CONTINUAL IMPROVEMENTS IN SCREENING UPTAKE AND ADJUVANT CANCER TREATMENTS, THE NUMBER OF CANADIAN WOMEN SURVIVING BREAST CANCER CONTINUES TO GROW. PRELIMINARY FINDINGS SUGGEST YOGA CAN IMPROVE QUALITY OF LIFE (QOL) IN BREAST CANCER SURVIVORS, BUT FEW STUDIES HAVE FOCUSED ON IYENGAR YOGA (IY). OBJECTIVE: THE PURPOSE OF THIS PILOT STUDY WAS TO EVALUATE THE IMPACT OF IY ON QOL AND PSYCHOSOCIAL FUNCTIONING IN A SELECT SAMPLE OF BREAST CANCER SURVIVORS. METHODS: BREAST CANCER SURVIVORS (N = 24) PARTICIPATING IN IY CLASSES COMPLETED A QUESTIONNAIRE MEASURING GENERIC AND DISEASE-SPECIFIC QOL AND PSYCHOSOCIAL FUNCTIONING, BEFORE AND AFTER THE 12-WEEK CLASSES. RESULTS: POSTPROGRAM QUESTIONNAIRES WERE COMPLETED BY 17 PARTICIPANTS (71%) WHO ATTENDED AN AVERAGE OF 78.9% OF THE IY SESSIONS. SEVERAL INDICATORS OF GENERIC QOL IMPROVED SIGNIFICANTLY, INCLUDING MENTAL HEALTH (MEAN CHANGE, +4.2; P = .045), VITALITY (MEAN CHANGE, +4.9; P = .033), ROLE-EMOTIONAL (MEAN CHANGE, +6.4; P = .010), AND BODILY PAIN (MEAN CHANGE, +4.4; P = .024). OTHER IMPROVEMENTS IN QOL AND PSYCHOSOCIAL FUNCTIONING WERE MEANINGFUL BUT WERE NOT STATISTICALLY SIGNIFICANT. FINDINGS WERE FURTHER SUBSTANTIATED BY PARTICIPANT'S EVALUATION OF THE PROGRAM'S BENEFITS AND MOTIVATIONAL VALUE. CONCLUSION: IN THIS PILOT STUDY OF BREAST CANCER SURVIVORS PARTICIPATING IN IY, WE FOUND IMPROVEMENTS IN QOL AND PSYCHOSOCIAL FUNCTIONING. MOREOVER, POSITIVE PROGRAM EVALUATION AND MOTIVATIONAL PROFILE PROVIDE SUPPORT FOR THE ACCEPTABILITY OF IY WITH BREAST CANCER SURVIVORS. RANDOMIZED CONTROLLED TRIALS COMPARING IY TO USUAL CARE AND OTHER FORMS OF YOGA IN BREAST CANCER SURVIVORS ARE WARRANTED. IMPLICATIONS FOR PRACTICE: NURSES MAY CONSIDER IY AS A POSSIBLE INTERVENTION STRATEGY TO HELP BREAST CANCER SURVIVORS IMPROVE THEIR QOL AND PSYCHOSOCIAL FUNCTIONING. 2010 7 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 8 2529 41 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 /=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 14 962 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 15 389 33 BENEFITS OF YOGA FOR AFRICAN AMERICAN HEART FAILURE PATIENTS. BACKGROUND: THE NUMBER OF AFRICAN AMERICAN (AA) PATIENTS LIVING WITH HEART FAILURE (HF) HAS BEEN INCREASING, ESPECIALLY AMONG THE ECONOMICALLY DISADVANTAGED. YOGA THERAPY HAS BEEN FOUND TO IMPROVE PHYSICAL AND PSYCHOLOGICAL PARAMETERS AMONG HEALTHY INDIVIDUALS, BUT ITS EFFECT IN PATIENTS WITH HF REMAINS UNKNOWN. THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE EFFECTS OF YOGA THERAPY ON CARDIOVASCULAR ENDURANCE (VO2PEAK), FLEXIBILITY, QUALITY OF LIFE (QOL), AND INFLAMMATORY MARKERS ON MEDICALLY STABLE HF PATIENTS. METHODS: FORTY PATIENTS (38 AA, 1 ASIAN, AND 1 CAUCASIAN) WITH SYSTOLIC OR DIASTOLIC HF WERE RANDOMIZED TO THE YOGA GROUP (YG, N = 21) OR THE CONTROL GROUP (CG, N = 19). ALL PATIENTS WERE ASKED TO FOLLOW A HOME WALK PROGRAM. PREMEASUREMENT AND POSTMEASUREMENT INCLUDED A TREADMILL STRESS TEST TO PEAK EXERTION, FLEXIBILITY, INTERLEUKIN-6 (IL-6), C-REACTIVE PROTEIN (CRP), AND EXTRACELLULAR SUPEROXIDE DISMUTASE (EC-SOD). QOL WAS ASSESSED BY THE MINNESOTA LIVING WITH HEART FAILURE QUESTIONNAIRE (MLWHFQ). RESULTS: THE STATISTICAL ANALYSES (ASSESSED BY ANOVA AND T-TESTS) WERE SIGNIFICANT FOR FAVORABLE CHANGES IN THE YG, COMPARED WITH THOSE IN THE CG, FOR FLEXIBILITY (P = 0.012), TREADMILL TIME (P = 0.002), VO2PEAK (P = 0.003), AND THE BIOMARKERS (IL-6, P = 0.004; CRP, P = 0.016; AND EC-SOD, P = 0.012). WITHIN THE YG, PRETEST TO POSTTEST SCORES FOR THE TOTAL (P = 0.02) AND PHYSICAL SUBSCALES (P < 0.001) OF THE MLWHFQ WERE IMPROVED. CONCLUSIONS: YOGA THERAPY OFFERED ADDITIONAL BENEFITS TO THE STANDARD MEDICAL CARE OF PREDOMINANTLY AA HF PATIENTS BY IMPROVING CARDIOVASCULAR ENDURANCE, QOL, INFLAMMATORY MARKERS, AND FLEXIBILITY. 2010 16 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 17 1859 45 RANDOMIZED CONTROLLED PILOT TRIAL OF YOGA IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS: EFFECTS ON QUALITY OF LIFE AND ANTHROPOMETRIC MEASURES. PURPOSE: TO OBTAIN ESTIMATES OF TIME TO RECRUIT THE STUDY SAMPLE, RETENTION, FACILITY-BASED CLASS ATTENDANCE AND HOME PRACTICE FOR A STUDY OF YOGA IN BREAST CANCER SURVIVORS, AND ITS EFFICACY ON FATIGUE, QUALITY OF LIFE (QOL), AND WEIGHT CHANGE. METHODS: SIXTY-THREE POST-TREATMENT STAGES 0-III BORDERLINE OVERWEIGHT AND OBESE (BODY MASS INDEX >/= 24 KG/M(2)) BREAST CANCER SURVIVORS WERE RANDOMLY ASSIGNED TO A 6-MONTH, FACILITY- AND HOME-BASED VINIYOGA INTERVENTION (N = 32) OR A WAITLIST CONTROL GROUP (N = 31). THE YOGA GOAL WAS FIVE PRACTICES PER WEEK. PRIMARY OUTCOME MEASURES WERE CHANGES IN QOL, FATIGUE, AND WEIGHT FROM BASELINE TO 6 MONTHS. SECONDARY OUTCOMES INCLUDED CHANGES IN WAIST AND HIP CIRCUMFERENCE. RESULTS: IT TOOK 12 MONTHS TO COMPLETE RECRUITMENT. PARTICIPANTS ATTENDED A MEAN OF 19.6 CLASSES AND PRACTICED AT HOME A MEAN OF 55.8 TIMES DURING THE 6-MONTH PERIOD. AT FOLLOW-UP, 90% OF PARTICIPANTS COMPLETED QUESTIONNAIRES AND 87% COMPLETED ANTHROPOMETRIC MEASUREMENTS. QOL AND FATIGUE IMPROVED TO A GREATER EXTENT AMONG WOMEN IN THE YOGA GROUP RELATIVE TO WOMEN IN THE CONTROL GROUP, ALTHOUGH NO DIFFERENCES WERE STATISTICALLY SIGNIFICANT. WAIST CIRCUMFERENCE DECREASED 3.1 CM (95% CI, -5.7 AND -0.4) MORE AMONG WOMEN IN THE YOGA COMPARED WITH THE CONTROL GROUP, WITH NO DIFFERENCE IN WEIGHT CHANGE. CONCLUSIONS: THIS STUDY PROVIDES IMPORTANT INFORMATION REGARDING RECRUITMENT, RETENTION, AND PRACTICE LEVELS ACHIEVED DURING A 6-MONTH, INTENSIVE YOGA INTERVENTION IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS. YOGA MAY HELP DECREASE WAIST CIRCUMFERENCE AND IMPROVE QUALITY OF LIFE; FUTURE STUDIES ARE NEEDED TO CONFIRM THESE RESULTS. 2012 18 2604 49 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 19 1750 29 PILOT STUDY OF YOGA FOR BREAST CANCER SURVIVORS WITH POOR QUALITY OF LIFE. INTRODUCTION: STUDIES SHOW BENEFITS OF YOGA FOR BREAST CANCER PATIENTS WITH POOR QUALITY OF LIFE (QOL); HOWEVER, NONE EXCLUSIVELY FOCUS ON SURVIVORS. THIS STUDY ADDRESSES WHETHER HATHA YOGA IMPROVES BREAST CANCER SURVIVORS' QOL. METHODS: 25 BREAST CANCER SURVIVORS COMPLETED SIX WEEKS OF YOGA. OUTCOME MEASURES WERE 5 QOL CATEGORIES EVALUATED USING THE FACT-B SURVEY PRE AND POST-INTERVENTION AND AFTER 6 MONTHS. RESULTS: EACH CATEGORY WAS EVALUATED INDEPENDENTLY, INCLUDING: PHYSICAL (PWB), SOCIAL (SWB), EMOTIONAL (EWB), FUNCTIONAL (FWB), BREAST CANCER SPECIFIC WELL-BEING (BCS), TRIAL OUTCOME INDEX (TOI), FACT-G, AND FACT-B. SIGNIFICANT IMPROVEMENT WAS FOUND IN ALL CATEGORIES EXCEPT SOCIAL WELL-BEING (PWB P = .013, EWB P = .005, FWB P = .003, BCS P < .001, TOI P < .001, FACT-G P = .004, FACT-B P < .001). PATIENTS WITH BELOW AVERAGE PRE-INTERVENTION INDEX SCORES (N = 13) SHOWED GREATER IMPROVEMENT IN EWB AND FWB, WHILE THOSE WITH ABOVE AVERAGE PRE-INTERVENTION SCORES (N = 9) SHOWED GREATER IMPROVEMENT IN PWB. CONCLUSIONS: YOGA MAY BE FEASIBLE AND CLINICALLY USEFUL FOR BREAST CANCER SURVIVORS WITH POOR QOL. 2012 20 2602 35 YOGA FOR PATIENTS WITH EARLY BREAST CANCER AND ITS IMPACT ON QUALITY OF LIFE - A RANDOMIZED CONTROLLED TRIAL. THE AIM OF THIS PROSPECTIVE, RANDOMIZED, CONTROLLED TRIAL WAS TO INVESTIGATE THE IMPACT OF YOGA ON NEWLY DIAGNOSED PATIENTS WITH EARLY BREAST CANCER IN THE IMMEDIATE POSTOPERATIVE PHASE. 93 WOMEN NEWLY DIAGNOSED WITH EARLY BREAST CANCER WERE RANDOMIZED INTO AN INTERVENTION GROUP (IG) AND A CONTROL GROUP (WAITING GROUP, WG). THE IG STARTED YOGA IMMEDIATELY AFTER THE OPERATION. THE WG STARTED YOGA 5 WEEKS AFTER SURGERY. BOTH GROUPS ATTENDED YOGA CLASSES TWICE WEEKLY FOR 5 WEEKS. QUALITY OF LIFE (QOL) WAS EVALUATED USING THE EORTC QLQ-C30 AND EORTC QLQ-BR23 QUESTIONNAIRES BEFORE THE INTERVENTION, IMMEDIATELY AFTER THE OPERATION AND AFTER 3 MONTHS. AFTER 3 MONTHS THE PATIENTS WERE ASKED WHETHER YOGA IMPROVED THEIR PHYSICAL ACTIVITY AND WHETHER THEY WISHED TO CONTINUE WITH YOGA. THE OVERALL QOL (P = 0.002) AND THE FUNCTIONAL STATUS (P = 0.005) INCREASED SIGNIFICANTLY IN THE IG, WHILE PHYSICAL SYMPTOMS DECREASED OVER TIME IN BOTH GROUPS. 86 % OF PATIENTS IN THE IG AND ONLY 59 % OF PATIENTS IN THE WG (P = 0.04) CONFIRMED A POSITIVE CHANGE IN THEIR PHYSICAL ACTIVITY THROUGH YOGA. MORE WOMEN IN THE IG INTENDED TO CONTINUE WITH YOGA (P = 0.03). EARLY INITIATION OF YOGA AS A SUPPORTIVE TREATMENT IN CANCER HAD A POSITIVE IMPACT ON QOL. TEACHING YOGA ALLOWED PATIENTS TO PRACTICE YOGA BY THEMSELVES, ENHANCED THE PATIENTS' QOL AND WAS FOUND TO IMPROVE PHYSICAL ACTIVITY. 2013