1 41 149 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 2 2093 40 THE EFFECT OF YOCAS(C)(R) YOGA FOR MUSCULOSKELETAL SYMPTOMS AMONG BREAST CANCER SURVIVORS ON HORMONAL THERAPY. UP TO 50% OF BREAST CANCER SURVIVORS ON AROMATASE INHIBITOR THERAPY REPORT MUSCULOSKELETAL SYMPTOMS SUCH AS JOINT AND MUSCLE PAIN, SIGNIFICANTLY IMPACTING TREATMENT ADHERENCE AND DISCONTINUATION RATES. WE CONDUCTED A SECONDARY DATA ANALYSIS OF A NATIONWIDE, MULTI-SITE, PHASE II/III RANDOMIZED, CONTROLLED, CLINICAL TRIAL EXAMINING THE EFFICACY OF YOGA FOR IMPROVING MUSCULOSKELETAL SYMPTOMS AMONG BREAST CANCER SURVIVORS CURRENTLY RECEIVING HORMONE THERAPY (AROMATASE INHIBITORS [AI] OR TAMOXIFEN [TAM]). BREAST CANCER SURVIVORS CURRENTLY RECEIVING AI (N = 95) OR TAM (N = 72) WITH NO PARTICIPATION IN YOGA DURING THE PREVIOUS 3 MONTHS WERE RANDOMIZED INTO 2 ARMS: (1) STANDARD CARE MONITORING AND (2) STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION (2X/WEEK; 75 MIN/SESSION) AND INCLUDED IN THIS ANALYSIS. THE YOGA INTERVENTION UTILIZED THE UR YOGA FOR CANCER SURVIVORS (YOCAS(C)((R))) PROGRAM CONSISTING OF BREATHING EXERCISES, 18 GENTLE HATHA AND RESTORATIVE YOGA POSTURES, AND MEDITATION. MUSCULOSKELETAL SYMPTOMS WERE ASSESSED PRE- AND POST-INTERVENTION. AT BASELINE, AI USERS REPORTED HIGHER LEVELS OF GENERAL PAIN, MUSCLE ACHES, AND TOTAL PHYSICAL DISCOMFORT THAN TAM USERS (ALL 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 6 127 49 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 7 2698 46 YOGA INTERVENTION AND REMINDER E-MAILS FOR REDUCING CANCER-RELATED FATIGUE - A STUDY PROTOCOL OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: ALMOST 90% OF CANCER PATIENTS SUFFER FROM SYMPTOMS OF FATIGUE DURING TREATMENT. SUPPORTING TREATMENTS ARE INCREASINGLY USED TO ALLEVIATE THE BURDEN OF FATIGUE. THIS STUDY EXAMINES THE SHORT-TERM AND LONG-TERM EFFECTS OF YOGA ON FATIGUE AND THE EFFECT OF WEEKLY REMINDER E-MAILS ON EXERCISE FREQUENCY AND FATIGUE SYMPTOMS. METHODS: THE AIM OF THE FIRST PART OF THE STUDY WILL EVALUATE THE EFFECTIVENESS OF YOGA FOR CANCER PATIENTS WITH MIXED DIAGNOSES REPORTING FATIGUE. WE WILL RANDOMLY ALLOCATE 128 PATIENTS TO AN INTERVENTION GROUP (N = 64) RECEIVING YOGA AND A WAIT-LIST CONTROL GROUP (N = 64) RECEIVING YOGA 9 WEEKS LATER. THE YOGA THERAPY WILL BE PERFORMED IN WEEKLY SESSIONS OF 60 MIN EACH FOR 8 WEEKS. THE PRIMARY OUTCOME WILL BE SELF-REPORTED FATIGUE SYMPTOMS. IN THE SECOND PART OF THE STUDY, THE EFFECTIVENESS OF REMINDER E-MAILS WITH REGARD TO THE EXERCISE FREQUENCY AND SELF-REPORTED FATIGUE SYMPTOMS WILL BE EVALUATED. A RANDOMIZED ALLOCATED GROUP OF THE PARTICIPANTS ("EMAIL") RECEIVES WEEKLY REMINDER E-MAILS, THE OTHER GROUP DOES NOT. DATA WILL BE ASSESSED USING QUESTIONNAIRES THE BEGINNING AND AFTER YOGA THERAPY AS WELL AS AFTER 6 MONTHS. DISCUSSION: SUPPORT OF PATIENTS SUFFERING FROM FATIGUE IS AN IMPORTANT GOAL IN CANCER PATIENTS CARE. IF YOGA THERAPY WILL REDUCE FATIGUE, THIS TYPE OF THERAPY MAY BE INTRODUCED INTO ROUTINE PRACTICE. IF THE REMINDER E-MAILS PROVE TO BE HELPFUL, NEW OFFERS FOR PATIENTS MAY ALSO DEVELOP FROM THIS. TRIAL REGISTRATION: GERMAN CLINCIAL TRIALS REGISTER ( DRKS00016034 , 12/2018), RETROSPECTIVELY REGISTERED. 2019 8 2156 34 THE EFFECTS OF THE BALI YOGA PROGRAM FOR BREAST CANCER PATIENTS ON CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING: RESULTS OF A PARTIALLY RANDOMIZED AND BLINDED CONTROLLED TRIAL. COMPLEMENTARY AND ALTERNATIVE MEDICINE HAS BEEN SHOWN TO BE BENEFICIAL IN REDUCING CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING. HOWEVER, CONCLUSIVE RESULTS ARE LACKING IN ORDER TO CONFIRM ITS USEFULNESS. THE PURPOSE OF THIS STUDY WAS TO DETERMINE WHETHER A STANDARDIZED YOGA INTERVENTION COULD REDUCE THESE ADVERSE SYMPTOMS. THIS WAS A PARTIALLY RANDOMIZED AND BLINDED CONTROLLED TRIAL COMPARING A STANDARDIZED YOGA INTERVENTION WITH STANDARD CARE. ELIGIBLE PATIENTS WERE ADULTS DIAGNOSED WITH STAGES I TO III BREAST CANCER RECEIVING CHEMOTHERAPY. PATIENTS RANDOMIZED TO THE EXPERIMENTAL GROUP PARTICIPATED IN AN 8-WEEK YOGA PROGRAM. THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN THE EXPERIMENTAL AND CONTROL GROUPS ON CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING AFTER 8 WEEKS. RESULTS SUGGEST THE YOGA PROGRAM IS NOT BENEFICIAL IN MANAGING THESE ADVERSE SYMPTOMS. HOWEVER, CONSIDERING PRELIMINARY EVIDENCE SUGGESTING YOGA'S BENEFICIAL IMPACT IN CANCER SYMPTOM MANAGEMENT, METHODOLOGICAL LIMITATIONS SHOULD BE EXPLORED AND ADDITIONAL STUDIES SHOULD BE CONDUCTED. 2017 9 172 61 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 10 2604 48 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 11 1495 59 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 12 1650 44 MULTICENTER, RANDOMIZED CONTROLLED TRIAL OF YOGA FOR SLEEP QUALITY AMONG CANCER SURVIVORS. PURPOSE: THIRTY PERCENT TO 90% OF CANCER SURVIVORS REPORT IMPAIRED SLEEP QUALITY POST-TREATMENT, WHICH CAN BE SEVERE ENOUGH TO INCREASE MORBIDITY AND MORTALITY. LIFESTYLE INTERVENTIONS, SUCH AS EXERCISE, ARE RECOMMENDED IN CONJUNCTION WITH DRUGS AND COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF IMPAIRED SLEEP. PRELIMINARY EVIDENCE INDICATES THAT YOGA-A MIND-BODY PRACTICE AND FORM OF EXERCISE-MAY IMPROVE SLEEP AMONG CANCER SURVIVORS. THE PRIMARY AIM OF THIS RANDOMIZED, CONTROLLED CLINICAL TRIAL WAS TO DETERMINE THE EFFICACY OF A STANDARDIZED YOGA INTERVENTION COMPARED WITH STANDARD CARE FOR IMPROVING GLOBAL SLEEP QUALITY (PRIMARY OUTCOME) AMONG POST-TREATMENT CANCER SURVIVORS. PATIENTS AND METHODS: IN ALL, 410 SURVIVORS SUFFERING FROM MODERATE OR GREATER SLEEP DISRUPTION BETWEEN 2 AND 24 MONTHS AFTER SURGERY, CHEMOTHERAPY, AND/OR RADIATION THERAPY WERE RANDOMLY ASSIGNED TO STANDARD CARE OR STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION. THE YOGA INTERVENTION USED THE YOGA FOR CANCER SURVIVORS (YOCAS) PROGRAM CONSISTING OF PRANAYAMA (BREATHING EXERCISES), 16 GENTLE HATHA AND RESTORATIVE YOGA ASANAS (POSTURES), AND MEDITATION. PARTICIPANTS ATTENDED TWO 75-MINUTE SESSIONS PER WEEK. SLEEP QUALITY WAS ASSESSED BY USING THE PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY PRE- AND POSTINTERVENTION. RESULTS: IN ALL, 410 SURVIVORS WERE ACCRUED (96% FEMALE; MEAN AGE, 54 YEARS; 75% HAD BREAST CANCER). YOGA PARTICIPANTS DEMONSTRATED GREATER IMPROVEMENTS IN GLOBAL SLEEP QUALITY AND, SECONDARILY, SUBJECTIVE SLEEP QUALITY, DAYTIME DYSFUNCTION, WAKE AFTER SLEEP ONSET, SLEEP EFFICIENCY, AND MEDICATION USE AT POSTINTERVENTION (ALL P /= 4 SESSIONS. EIGHTY PERCENT OF PARTICIPANTS IN THE YOGA CONDITION AND 65% IN THE SUPPORT GROUP INDICATED THAT THEY WERE HIGHLY SATISFIED WITH THE INTERVENTION. FOLLOWING TREATMENT, WOMEN IN THE YOGA INTERVENTION HAD MODEST IMPROVEMENTS IN SOME OUTCOMES; HOWEVER, OVERALL SYMPTOM LEVELS WERE LOW FOR WOMEN IN BOTH CONDITIONS. CONCLUSIONS: FINDINGS SUGGEST THAT THE YOGA INTERVENTION CONTENT WAS HIGHLY ACCEPTABLE TO PATIENTS WITH MBC, BUT THAT THERE ARE CHALLENGES TO IMPLEMENTING AN INTERVENTION INVOLVING EIGHT GROUP-BASED IN-PERSON SESSIONS. ALTERNATIVE MODES OF DELIVERY MAY BE NECESSARY TO REACH PATIENTS MOST IN NEED OF INTERVENTION. 2019 17 2508 58 YOGA BREATHING FOR CANCER CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE: RESULTS OF A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: MANY DEBILITATING SYMPTOMS ARISE FROM CANCER AND ITS TREATMENT THAT ARE OFTEN UNRELIEVED BY ESTABLISHED METHODS. PRANAYAMA, A SERIES OF YOGIC BREATHING TECHNIQUES, MAY IMPROVE CANCER-RELATED SYMPTOMS AND QUALITY OF LIFE, BUT IT HAS NOT BEEN STUDIED FOR THIS PURPOSE. OBJECTIVES: A PILOT STUDY WAS PERFORMED TO EVALUATE FEASIBILITY AND TO TEST THE EFFECTS OF PRANAYAMA ON CANCER-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. DESIGN: THIS WAS A RANDOMIZED CONTROLLED CLINICAL TRIAL COMPARING PRANAYAMA TO USUAL CARE. SETTING: THE STUDY WAS CONDUCTED AT A UNIVERSITY MEDICAL CENTER. SUBJECTS: PATIENTS RECEIVING CANCER CHEMOTHERAPY WERE RANDOMIZED TO RECEIVE PRANAYAMA IMMEDIATELY OR AFTER A WAITING PERIOD (CONTROL GROUP). INTERVENTIONS: THE PRANAYAMA INTERVENTION CONSISTED OF FOUR BREATHING TECHNIQUES TAUGHT IN WEEKLY CLASSES AND PRACTICED AT HOME. THE TREATMENT GROUP RECEIVED PRANAYAMA DURING TWO CONSECUTIVE CYCLES OF CHEMOTHERAPY. THE CONTROL GROUP RECEIVED USUAL CARE DURING THEIR FIRST CYCLE, AND RECEIVED PRANAYAMA DURING THEIR SECOND CYCLE OF CHEMOTHERAPY. OUTCOME MEASURES: FEASIBILITY, CANCER-ASSOCIATED SYMPTOMS (FATIGUE, SLEEP DISTURBANCE, ANXIETY, DEPRESSION, STRESS), AND QUALITY OF LIFE WERE THE OUTCOMES. RESULTS: CLASS ATTENDANCE WAS NEARLY 100% IN BOTH GROUPS. SIXTEEN (16) PARTICIPANTS WERE INCLUDED IN THE FINAL INTENT-TO-TREAT ANALYSES. THE REPEATED-MEASURES ANALYSES DEMONSTRATED THAT ANY INCREASE IN PRANAYAMA DOSE, WITH DOSE MEASURED IN THE NUMBER OF HOURS PRACTICED IN CLASS OR AT HOME, RESULTED IN IMPROVED SYMPTOM AND QUALITY-OF-LIFE SCORES. SEVERAL OF THESE ASSOCIATIONS--SLEEP DISTURBANCE (P=0.04), ANXIETY (P=0.04), AND MENTAL QUALITY OF LIFE (P=0.05)--REACHED OR APPROACHED STATISTICAL SIGNIFICANCE. CONCLUSIONS: YOGA BREATHING WAS A FEASIBLE INTERVENTION AMONG PATIENTS WITH CANCER RECEIVING CHEMOTHERAPY. PRANAYAMA MAY IMPROVE SLEEP DISTURBANCE, ANXIETY, AND MENTAL QUALITY OF LIFE. A DOSE-RESPONSE RELATIONSHIP WAS FOUND BETWEEN PRANAYAMA USE AND IMPROVEMENTS IN CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. THESE FINDINGS NEED TO BE CONFIRMED IN A LARGER STUDY. 2012 18 2627 24 YOGA FOR THE MANAGEMENT OF CANCER TREATMENT-RELATED TOXICITIES. PURPOSE OF REVIEW: TO (1) EXPLAIN WHAT YOGA IS, (2) SUMMARIZE PUBLISHED LITERATURE ON THE EFFICACY OF YOGA FOR MANAGING CANCER TREATMENT-RELATED TOXICITIES, (3) PROVIDE CLINICAL RECOMMENDATIONS ON THE USE OF YOGA FOR ONCOLOGY PROFESSIONALS, AND (4) SUGGEST PROMISING AREAS FOR FUTURE RESEARCH. RECENT FINDINGS: BASED ON A TOTAL OF 24 PHASE II AND ONE PHASE III CLINICAL TRIALS, LOW-INTENSITY FORMS OF YOGA, SPECIFICALLY GENTLE HATHA AND RESTORATIVE, ARE FEASIBLE, SAFE, AND EFFECTIVE FOR TREATING SLEEP DISRUPTION, CANCER-RELATED FATIGUE, COGNITIVE IMPAIRMENT, PSYCHOSOCIAL DISTRESS, AND MUSCULOSKELETAL SYMPTOMS IN CANCER PATIENTS RECEIVING CHEMOTHERAPY AND RADIATION AND CANCER SURVIVORS. CLINICIANS SHOULD CONSIDER PRESCRIBING YOGA FOR THEIR PATIENTS SUFFERING WITH THESE TOXICITIES BY REFERRING THEM TO QUALIFIED YOGA PROFESSIONALS. MORE DEFINITIVE PHASE III CLINICAL TRIALS ARE NEEDED TO CONFIRM THESE FINDINGS AND TO INVESTIGATE OTHER TYPES, DOSES, AND DELIVERY MODES OF YOGA FOR TREATING CANCER-RELATED TOXICITIES IN PATIENTS AND SURVIVORS. 2018 19 929 45 EFFECTIVENESS OF YOGA ON QUALITY OF LIFE OF BREAST CANCER PATIENTS UNDERGOING CHEMOTHERAPY: A RANDOMIZED CLINICAL CONTROLLED STUDY. BACKGROUND: CANCER OF BREAST IS MOST COMMON CANCER AMONG WOMEN IN INDIA AND VAST MAJORITY OF COUNTRIES WORLDWIDE. WHILE UNDERGOING CHEMOTHERAPY FOR CARCINOMA MANAGEMENT, WOMEN ENCOUNTER SIDE EFFECTS, WHICH AFFECTS THEIR QUALITY OF LIFE (QOL). A RANDOMIZED CONTROLLED STUDY WITH QUANTITATIVE RESEARCH APPROACH AND TIME SERIES DESIGN WAS CONDUCTED, TO STUDY THE EFFECTIVENESS OF YOGA ON QOL OF BREAST CANCER PATIENTS UNDERGOING CHEMOTHERAPY. METHODOLOGY: ONE HUNDRED BREAST CANCER PATIENTS SCHEDULED FOR 3-WEEKLY, DAY-CARE ADJUVANT CHEMOTHERAPY (CEF REGIMEN) WERE ENROLLED WITH CONSECUTIVE SAMPLING TECHNIQUE, INTO CONTROL (N = 52) AND EXPERIMENT (N = 48) GROUPS, BY CONCEALED RANDOMIZATION FOLLOWING WRITTEN INFORMED CONSENT. BASELINE DATA ON QOL WERE COLLECTED BEFORE FIRST-CYCLE CHEMOTHERAPY USING THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER QLQ C30. PATIENTS IN THE EXPERIMENTAL GROUP WERE TAUGHT DIAPHRAGMATIC BREATHING TECHNIQUES, SYSTEMATIC RELAXATION, AND ALTERNATE NOSTRIL BREATHING, AND JOINTS AND GLANDS NECK AND SHOULDER EXERCISES WERE INSTRUCTED TO PRACTICE TWICE DAILY AT HOME. THEY WERE SUPERVISED IN PRACTICING THESE TECHNIQUES WHILE THEY RECEIVED SECOND, THIRD, FOURTH, FIFTH, AND SIXTH CYCLES OF CHEMOTHERAPY IN THE DAY-CARE FACILITY. PARTICIPANTS IN THE CONTROL GROUP RECEIVED ONLY ROUTINE CARE. ALL PARTICIPANTS RECEIVED STANDARD POST CHEMOTHERAPY PRESCRIPTION. DATA ON QOL WERE COLLECTED FROM ALL PATIENTS DURING THE SECOND, THIRD, FOURTH, FIFTH, AND SIXTH CYCLES OF CHEMOTHERAPY. RESULTS: THE ANALYSIS REVEALED THAT AT THE BASELINE (FIRST CHEMOTHERAPY CYCLE), BREAST CANCER PATIENTS IN CONTROL AND EXPERIMENTAL GROUPS WERE HOMOGENEOUS IN TERMS OF THEIR SOCIODEMOGRAPHIC AND CLINICAL VARIABLES AND QOL SCORE. YOGA PRACTICES WERE EFFECTIVE IN IMPROVING THE QOL OF BREAST CANCER PATIENTS IN THE EXPERIMENTAL GROUP IN THE AREAS OF GLOBAL HEALTH STATUS, PHYSICAL FUNCTION, ROLE FUNCTION, AND EMOTIONAL FUNCTION AND DECREASING THE SYMPTOMS OF FATIGUE, INSOMNIA, LOSS OF APPETITE, AND CONSTIPATION, DURING THE PERIOD OF CHEMOTHERAPY. CONCLUSION: YOGA PRACTICES COMPRISING OF RELAXATION TECHNIQUES REDUCE MANY SIDE EFFECTS AND IMPROVE THE QOL OF WOMEN UNDERGOING CHEMOTHERAPY FOR BREAST CANCER. 2020 20 1787 35 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH. 2015