Performance accomplishment Structured experience Verbal support Physical feedback
Themes discovered: (i) empowerment (importance of camaraderie, community, and sharing) (ii) pain relief (iii) increased physical fitness (energy, flexibility, and function); relieved stress/anxiety (iv) transferability of yoga through breathing
Viniyoga (at home or classes) versus wait list 5x/week for 6 months
RCT
63 Obese and overweight women (BMI ≥ 24)
Feasibility (time to recruit, retention, adherence) QOL (FACT-G, FACT-B) Fatigue (FACIT-F) Weight and height Waist and hip circumference
12 months to recruit Attendance was 20 classes and 56 at home practices in 6 months 51% were satisfied the program Trend towards improved QOL and fatigue Decreased waist circumference by −3.1cm* No change in weight, BMI, and hip circumference
Fatigue (FSI) Depression (BDI-II) Sleep (PSQI) Pain (BCPTSS) QOL (SF-36) Physical function (8-foot walk test, chair stands) Program Evaluation
Decreased fatigue and number of days with fatigue/week
* Improved vitality, depression, and general health* No difference in sleep Trend towards decreased pain All improvements persisted at 3 months after intervention* Improvement in physical function* High satisfaction with the program
17.7% breast cancer survivors used versus 6% in general population Yoga use associated with white race, lower BMI, higher education, higher socioeconomic status, part-time employment, stage II cancer,previous chemotherapy, and previous radiotherapy* In multivariate analysis, yoga use was associated with higher education and lower BMI*
QOL (SF-36, FACT-B) Fatigue (FSI) Stress (PSS) Anxiety (STAI) Depression (CESSDS) Body image (brief body image scale) Self-esteem (Rosenberg Self-Esteem Scale) Happiness (the happiness measure) Motivational outcomes Program evaluation
Improved generic QOL (mental health, vitality, pain, and roleemotional)
* Trend of improvement in breast specific-QOL Trend of improvement on stress, depression, body image, and self-esteem Strong motivational response Very high satisfaction with the program, very high perceived benefit
QOL Fatigue Meaning finding Intrusive thoughts Sleep Depression/anxiety
Improved health perception, physical functioning scores, more intrusive thoughts, and greater meaning finding
* No difference in fatigue, depression, sleep
Integrated yoga program (18–24, 60′ sessions) plus brief supportive therapy (every 10 days) versus brief supportive therapy (every 10 days)
RCT
88 Stage II-III Undergoing radiotherapy
QOL (EORTCQOL C30) functional scales Affect (PANAS)
Improved positive affect
* Improved emotional function* Improved cognitive function* Decrease in negative affect* Positive correlation between positive affect and physical, emotional, cognitive, and social function and global QOL *
Hot flashes before, after, and at 3 months after intervention
Decreased hot flash frequency, severity, and total score
* Improved joint pain, fatigue, sleep, bother, vigor, negative mood* (maintained at 3 months) More time practicing positively correlated with less fatigue, less bother, and more acceptance *
Restorative yoga versus wait list Weekly 75′ sessions 10 weeks
RCT
44 34% in active treatment
Physical Health (SF-12) QOL (FACT-B) Fatigue (FACT-Fatigue) Spiritual well-being (FACIT-Sp) Depression (CES-D) Sleep (PSQI) Affect (PANAS) Feasibility Program Evaluation
Improved mental health, depression, positive affect, and spirituality
* Greatest benefit on participants with higher negative affect and lower emotional well-being at baseline* Trend towards decreased sleep latency and increased QOL Recruitment 19%, adherence 58%- higher in women with higher baseline physical health and QOL High satisfaction with class, no adverse events
Integrated yoga program (1–7 weekly 60′ sessions for 24 weeks) plus 3-4 brief supportive therapy every 10 days versus brief supportive therapy every 10 days
RCT
98 Stage II-III Radiotherapy Chemotherapy
Anxiety (STAI) Symptom checklist
Decreased anxiety andsymptom severity
* Anxiety states positively correlate with symptoms severity and distress *
Integrated yoga program versus supportive therapy + exercise rehabilitation 4 weeks
RCT
98 Stage II-III Immediately at diagnosis
Anxiety (STAI) Depression (BDI) QOL (FLIC) Symptom checklist Lymphocytes, Immunoglobulins Cytokines Hospital stay Drain retention Time to suture removal Postoperative complications
Decreased anxiety, depression, and treatment-related symptoms after surgery
* Increased QOL after surgery Less decrease in CD56% after surgery* Decrease in IgA levels after surgery* Significant decrease in hospital stay, drain retention, days to suture removal* Decreased TNFαafter surgery*
51 Breast and ovarian cancer ( with breast cancer)
Physical Health (SF-12) QOL (FACT-G) Spiritual well-being (FACIT-Sp) Fatigue (FACT-Fatigue) Depression (CES-D) Anxiety (STAI) Affect (PANAS) Feasibility Program evaluation
Improvedmental health, QOL, fatigue, depression, state anxiety, and negative effect
* No change in positive affect and spiritual well-being Better adherence was associated with better physical health High satisfaction with the program (88% positive)
Integrated yoga by instructor (at chemo and every 10 days and at home 60′ daily) versus supportive therapy (30–60′ at chemo and every 10 days)
RCT
62 Stage II-III Postmastectomy Post radiation Undergoing chemotherapy
Nausea and emesis (MANE) Anxiety (STAI) Depression (BDI) QOL (FLIC) Symptom check list Treatment-related toxicity and side-effects (WHO Toxicity criteria)
Reduced frequency and intensity of chemo-associated nausea
* Trend towards reduced frequency and intensity of chemo-associated vomiting* Reduced intensity and frequency of anticipatory nausea and vomiting* Nausea and vomiting (both anticipatory and after chemo), positively correlated with anxiety, depression, distress, and chemo-related toxicity and negatively with QOL* Decreased anxiety, depression, and distress* Increased QOL* Decreased treatment toxicity * *
Hatha yoga versus wait list 12 weekly −90′ sessions
RCT
128 Ethnically diverse
QOL (FACT-B, FACT-G) Fatigue (FACIT-F) Spirituality (FACIT-Sp) Depressed mood Index mood (POMS) Adherence Program evaluation
Less decrease in social well-being
* Subgroup analysis for nonchemo patients: improved QOL, emotional, social, and spiritual well-being, distressed mood, anxiety, and irritability* Adherence was positively associated with physical well-being and negatively associated with fatigue and distressed mood* Breathing and meditation components were rated higher than the social connection
Daily measures of pain, fatigue, distress, invigoration, acceptance, and relaxation Focus group feedback Focus Group Questionnaire
Increase in daily invigoration and acceptance
* Trend towards improvements in pain and relaxation Greater yoga practice positively associated with decreased pain, increased invigoration, and acceptance* Greater yoga practice positively associated with decreased next-day pain and fatigue and increased invigoration, relaxation, and acceptance* Program was considered overall very helpful
Modified Hatha yoga versus wait list 7 weeks of weekly 75′ sessions
RCT
38
Mood (POMS) Response to stress (SOSI) QOL (EORTC QLQ-C30) Physical activity (LSI) Fitness (CPA-FLA)
Improvements in QOL, emotional functioning, and diarrhea
* Trend toward improved emotional irritability, gastrointestinal symptoms, cognitive disorganization, mood, tension, depression, and confusion No difference in physical activity and fitness
AIs: Aromatase Inhibitors; BCPTSS: Breast Cancer Symptom Scale; BDS: Beck Depression Scale; BDI: Beck Depression Inventory; BPI: Brief Pain Inventory; CAM: Complementary and Alternative Medicine; CES-D: Center for Epidemiologic Studies-Depression Scale; CPA-FLA: Canadian Physical Activity, Fitness and Lifestyle Appraisal; EORTC QLQ-C30: European Organization for Research and Treatment Core Quality of Life Questionnaire-C30; FACT-B: Functional Assessment of Cancer Therapies-Breast; FACT-G: Functional Assessment of Cancer Therapies-General; FACIT-F: Functional Assessment of Chronic Illness Therapy-Fatigue; FACIT-Sp: Functional Assessment of Chronic Illness Therapy-Spirituality; FLIC: Functional Living Index for Cancer; FSI: Fatigue Symptom Inventory; GHQ-12: General Health Questionnaire-12; HADS: Hospital Anxiety and Depression Scale; IL-2R: Interleukin 2 Receptor; INF: Interferon; LOT-R: Life Orientation Test-Revised; LSI: Leisure Score Index; MANE: Morrow Assessment of Nausea and Emesis; MFSI: Multidimensional Fatigue Symptom Inventory; NHP: Nottingham Health Profile; PANAS: Positive and Negative Affect Schedule; POMS: Profile of Mood States; PSFS: Patient-Specific Functional Scale; PSQI: Pittsburgh Sleep Quality Inventory; PSS: Perceived Stress Scale; RCT: randomized controlled study (yoga versus control group); QOL: Quality of Life; RSCL: Rotterdam Symptom Checklist; RSES: Rosenberg; Self-Esteem Scale; SF-12: Short Form-12 Health Survey; SF-36: Medical Outcome Studies Short Form; SOSI: Symptoms of Stress Inventory; STAI: State Trait Anxiety Inventory; TNF: Tumor Necrosis Factor; bold text with* : statistically significant ().