Patient Activation through Counseling and Exercise – Acute Leukemia (PACE-AL) – a randomized controlled trial The Quality of Life Questionnaire Core 30 (QLQ-C30) and Functional Assessment of Cancer-General (FACT-G) differ in responsiveness, relative efficiency, and therefore required sample size. Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma Effects of an integrated yoga programme on chemotherapy-induced nausea and emesis in breast cancer patients. A randomized trial of yoga for adolescents with irritable bowel syndrome. Effects of yoga program on quality of life and affect in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Effects of exercise in combination with epoetin alfa during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for multiple myeloma. A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Does practicing hatha yoga satisfy recommendations for intensity of physical activity which improves and maintains health and cardiovascular fitness? Effects of an exercise program on muscle performance in patients undergoing allogeneic bone marrow transplantation Moderator Effects in a Randomized Controlled Trial of Exercise Training in Lymphoma Patients The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy Complementary and alternative medicine use among long‐term lymphoma survivors: A pilot study Restorative yoga for women with breast cancer: findings from a randomized pilot study. Psychometric evaluation of the Pittsburgh Sleep Quality Index in cancer patients. Long-term quality of life after breast cancer: a French registry-based controlled study Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors Resilience in Children Undergoing Stem Cell Transplantation: Results of a Complementary Intervention Trial Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. Fitness of Children With Standard-risk Acute Lymphoblastic Leukemia During Maintenance Therapy: Response to a Home-based Exercise and Nutrition Program Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial. Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: results of a pilot randomized controlled trial. Psychological distress two years after diagnosis of breast cancer: frequency and prediction. Yoga training improves quality of life in women with asthma. Using qualitative evaluation in a feasibility study to improve and refine a complementary therapy intervention prior to subsequent research. Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life.
Background Patients with acute leukemia experience a substantial symptom burden and are at risk of developing infections throughout the course of repeated cycles of intensive chemotherapy . Physical activity in recent years has been a strategy for rehabilitation in cancer patients to remedy disease and treatment related symptoms and side effects . To date , there are no clinical practice exercise guidelines for patients with acute leukemia undergoing induction and consolidation chemotherapy . A r and omized controlled trial is needed to determine if patients with acute leukemia can benefit by a structured and supervised counseling and exercise program . Methods / design This paper presents the study protocol : Patient Activation through Counseling and Exercise – Acute Leukemia ( PACE-AL ) trial , a two center , r and omized controlled trial of 70 patients with acute leukemia ( 35 patients / study arm ) following induction chemotherapy in the outpatient setting . Eligible patients will be r and omized to usual care or to the 12 week exercise and counseling program .  The intervention includes 3 hours + 30 minutes per week of supervised and structured aerobic training ( moderate to high intensity 70 - 80 % ) on an ergometer cycle , strength exercises using h and weights and relaxation exercise . Individual health counseling sessions include a self directed home walk program with a step counter . The primary endpoint is functional performance/exercise capacity ( 6 minute walk distance ) . The secondary endpoints are submaximal VO2 max test , sit to st and and bicep curl test , physical activity levels , patient reported outcomes ( quality of life , anxiety and depression , symptom prevalence , intensity and interference ) . Evaluation of clinical outcomes will be explored including incidence of infection , hospitalization days , body mass index , time to recurrence and survival . Qualitative exploration of patients ’ health behavior and experiences . Discussion PACE-AL will provide evidence of the effect of exercise and health promotion counseling on functional and physical capacity , the symptom burden and quality of life in patients with acute leukemia during out patient management . The results will inform clinical practice exercise guidelines and rehabilitation programs for patients undergoing treatment for acute leukemia . Optimizing the treatment and care pathway may ease the transition for patients from illness to the resumption of everyday activities . Trial registration Clinical Trials.gov Identifier : NCT01404520 OBJECTIVES  Quality of Life Question naire Core 30 ( QLQ-C30 ) and Functional Assessment of Cancer Therapy-General ( FACT-G ) are widely used cancer-specific health-related  quality of life  ( HRQOL  ) question naires . We aim ed to compare their responsiveness with clinical ly important effects and statistical efficiency to detect such effects . STUDY DESIGN AND SETTING Secondary analysis of QLQ-C30 and FACT-G data from a r and omized controlled trial of Medical Qigong ( n = 162 heterogeneous cancer patients ) .  Difference in responsiveness ( DR ) and relative efficiency ( RE ) were calculated for five domains . RESULTS FACT-G total score was more efficient than QLQ-C30 global scale for detecting change within the intervention arm [ RE = 0.31 ( 0.083 , 0.69 ) ] and comparing change between trial arms [ RE = 0.17 ( 0.009 , 0.58 ) ] . In the social domain , the QLQ-C30 scale was more responsive [ DR = 0.28 ( 0.024 , 0.54 ) ] and more efficient within arm only [ RE = 5.25 ( 1.21 , 232.26 ) ] . In the physical , functional/role , and emotional domains , neither question naire was more responsive or efficient . CONCLUSION FACT-G would require about one-third the sample of QLQ-C30 to detect a given change in overall HRQOL , whereas in the social domain , it would require five times the sample size . FACT-G won advantage in overall HRQOL by reduced " noise " ( smaller st and ard deviation achieved by summing across 27 items ) , whereas QLQ-C30 won advantage in the social domain via a larger " signal " ( achieved through well-targeted item content ) Research suggests that stress‐reduction programs tailored to the cancer setting help patients cope with the effects of treatment and improve their quality of life .  Yoga , an ancient Eastern science , incorporates stress‐reduction techniques that include regulated breathing , visual imagery , and meditation as well as various postures . The authors examined the effects of the  Tibetan yoga ( TY ) practice s of Tsa lung and Trul khor , which incorporate  controlled breathing and visualization , mindfulness techniques  , and low‐impact postures  in patients with lymphoma This study examined the effect of an integrated yoga programme on chemotherapy-related nausea and emesis in early operable breast cancer out patients . Sixty-two subjects were r and omly allocated to receive yoga ( n = 28 ) or supportive therapy intervention ( n = 34 ) during the course of their chemotherapy . Both groups had similar socio-demographic and medical characteristics . Intervention consisted of both supervised and home practice of yoga sessions lasting for 60 min daily , while the control group received supportive therapy and coping preparation during their hospital visits over a complete course of chemotherapy . The primary outcome measure was the Morrow Assessment of Nausea and Emesis ( MANE ) assessed after the fourth cycle of chemotherapy . Secondary outcomes included measures for anxiety , depression , quality of life , distressful symptoms and treatment-related toxicity assessed before and during the course of chemotherapy . Following yoga , there was a significant decrease in post-chemotherapy-induced nausea frequency ( P = 0.01 ) and nausea intensity ( P = 0.01 ) , and intensity of anticipatory nausea ( P = 0.01 ) and anticipatory vomiting ( P = 0.05 ) as compared with the control group . There was a significant positive correlation between MANE scores and anxiety , depression and distressful symptoms . In conclusion , the results suggest a possible use for stress reduction interventions such as yoga in complementing conventional antiemetics to manage chemotherapy-related nausea and emesis BACKGROUND Adolescents with irritable bowel syndrome ( IBS ) frequently experience interference with everyday activities . Mind-body approaches such as yoga have been recommended as interventions for patients with IBS . Despite promising results among adult sample s , there have been limited studies exploring the efficacy of yoga with pediatric patients . OBJECTIVE To conduct a preliminary r and omized study of yoga as treatment for adolescents with IBS . METHODS Twenty-five adolescents aged 11 to 18 years with IBS were r and omly assigned to either a yoga or wait list control group . Before the intervention , both groups completed question naires assessing gastrointestinal symptoms , pain , functional disability , coping , anxiety and depression . The yoga intervention consisted of a 1 h instructional session , demonstration and practice , followed by four weeks of daily home practice guided by a video . After four weeks , adolescents repeated the baseline question naires . The wait list control group then received the yoga intervention and four weeks later completed an additional set of question naires . RESULTS Adolescents in the yoga group reported lower levels of functional disability , less use of emotion-focused avoidance and lower anxiety following the intervention than adolescents in the control group . When the pre- and postintervention data for the two groups were combined , adolescents had significantly lower scores for gastrointestinal symptoms and emotion-focused avoidance following the yoga intervention . Adolescents found the yoga to be helpful and indicated they would continue to use it to manage their IBS . CONCLUSIONS Yoga holds promise as an intervention for adolescents with IBS OBJECTIVES This study compares the effects of an integrated yoga program with brief supportive therapy in breast cancer out patients undergoing adjuvant radiotherapy at a cancer centre . METHODS Eighty-eight stage II and III breast cancer out patients were r and omly 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 . Assessment s included European Organization for Research in the Treatment of Cancer- Quality of Life ( EORTCQoL C30 ) functional scales and Positive and Negative Affect Schedule ( PANAS ) . Assessment s were done at baseline and after 6 weeks of radiotherapy treatment . RESULTS An intention to treat GLM repeated measures ANOVA showed significant difference across groups over time for positive affect , negative affect and emotional function and social function . There was significant improvement in positive affect ( ES = 0.59 , p = 0.007 , 95%CI 1.25 to 7.8 ) , emotional function ( ES = 0.71 , p = 0.001 , 95%CI 6.45 to 25.33 ) and cognitive function ( ES = 0.48 , p = 0.03 , 95%CI 1.2 to 18.5 ) , and decrease in negative affect ( ES = 0.84 , p<0.001 , 95%CI -13.4 to -4.4 ) in the yoga group as compared to controls . There was a significant positive correlation between positive affect with role function , social function and global quality of life . There was a significant negative correlation between negative affect with physical function , role function , emotional function and social function . CONCLUSION The results suggest a possible role for yoga to improve quality of life and affect in breast cancer out patients PURPOSE / OBJECTIVES To determine the effect of aerobic and strength resistance training and epoetin alfa ( EPO ) therapy on transfusions , stem cell collection s , transplantation recovery , and multiple myeloma treatment response . DESIGN R and omized clinical trial . SETTING A myeloma research and therapy center in the south central United States . SAMPLE 135 patients with multiple myeloma , 120 evaluable . METHODS R and om assignment to exercise or usual care groups . All patients received EPO based on an algorithm . Aerobic capacity , using the six-minute walk test , was assessed prior to induction chemotherapy , prior to stem cell mobilization , and following stem cell collection for all patients and before and after transplantation for patients continuing in the study . Data analysis included analysis of variance to compare other outcome variables by groups . MAIN RESEARCH VARIABLES Number of red blood cell and platelet transfusions during transplantation , number of attempts at and total number of days of stem cell collection , time to recovery after transplantation , and response to intensive therapy for multiple myeloma . FINDINGS Recovery and treatment response were not significantly different between groups after transplantation . The exercise group had significantly fewer red blood cell transfusions and fewer attempts at stem cell collection . Serious adverse events were similar in each group . CONCLUSIONS Exercise with prophylactic EPO therapy reduces the number of RBC transfusions and attempts at stem cell collection for patients receiving intensive treatment for multiple myeloma . IMPLICATION S FOR NURSING Exercise is safe and has many physiologic benefits for patients receiving multiple myeloma treatment BACKGROUND Physical activity provides a number of physical and psychological benefits to cancer survivors , including lessening the impact of detrimental cancer-related symptoms and treatment side-effects ( e.g. fatigue , nausea ) , and improving overall well-being and quality of life . The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer survivors . METHOD Eligible participants ( per-screened with PAR-Q/PAR-MED-X ) were r and omly assigned to either the  intervention ( n=20 ) or control group ( n=18 ) . All participants completed pre- and post-testing assessment s immediately before and after the yoga program , respectively . RESULTS The yoga program participants ( M age=51.18 ( 10.33 ) ; 92 % female ) included primarily breast cancer survivors , on average 55.95 ( 54.39 ) months post-diagnosis . Significant differences between the intervention and the control group at post-intervention were seen only in psychosocial ( i.e. global quality of life , emotional function , and diarrhea ) variables ( all p 's < 0.05 ) . There were also trends for group differences , in the hypothesized directions , for the psychosocial variables of emotional irritability , gastrointestinal symptoms , cognitive disorganization , mood disturbance , tension , depression , and confusion ( all p 's < 0.10 ) . Finally , there were also significant improvements in both the program participants and the controls from pre- to post-intervention on a number of physical fitness variables . CONCLUSIONS These initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors . Future research might attempt to include a broader range of participants ( e.g. other types of cancer diagnoses , male subjects ) , a larger sample size , and a longer program duration in an RCT Background Little is known about the metabolic and heart rate responses to a typical hatha yoga session . The purpose s of this study were 1 ) to determine whether a typical yoga practice using various postures meets the current recommendations for levels of physical activity required to improve and maintain health and cardiovascular fitness ; 2 ) to determine the reliability of metabolic costs of yoga across sessions ; 3 ) to compare the metabolic costs of yoga practice to those of treadmill walking . Methods In this observational study , 20 intermediate-to-advanced level yoga practitioners , age 31.4 ± 8.3 years , performed an exercise routine inside a human respiratory chamber ( indirect calorimeter ) while wearing heart rate monitors . The exercise routine consisted of 30 minutes of sitting , 56 minutes of beginner-level hatha yoga administered by video , and 10 minutes of treadmill walking at 3.2 and 4.8 kph each . Measures were mean oxygen consumption ( VO2 ) , heart rate ( HR ) , percentage predicted maximal heart rate ( % MHR ) , metabolic equivalents ( METs ) , and energy expenditure ( kcal ) . Seven subjects repeated the protocol so that measurement reliability could be established . Results Mean values across the entire yoga session for VO2 , HR , % MHR , METs , and energy/min were 0.6 L/kg/min ; 93.2 beats/min ; 49.4 % ; 2.5 ; and 3.2 kcal/min ; respectively . Results of the ICCs ( 2,1 ) for mean values across the entire yoga session for kcal , METs , and % MHR were 0.979 and 0.973 , and 0.865 , respectively . Conclusion Metabolic costs of yoga averaged across the entire session represent low levels of physical activity , are similar to walking on a treadmill at 3.2 kph , and do not meet recommendations for levels of physical activity for improving or maintaining health or cardiovascular fitness . Yoga practice incorporating sun salutation postures exceeding the minimum bout of 10 minutes may contribute some portion of sufficiently intense physical activity to improve cardio-respiratory fitness in unfit or sedentary individuals . The measurement of energy expenditure across yoga sessions is highly reliable Summary : Allogeneic bone marrow transplantation ( BMT ) has been successfully used for the treatment of several hematological malignancies ; however , it is associated with transplant-related toxicities such as functional impairment and muscle weakness . In order to analyze how an exercise program may influence muscle strength in patients undergoing BMT  , we carried out a prospect i ve study assessing patients from the pre-BMT phase to 16 weeks post-BMT .  In all , 18 patients underwent three trials : ( 1 ) pre-BMT , ( 2 ) after marrow engraftment , and ( 3 ) 6 weeks after trial 2 . After trial 2 , the patients were r and omized in a control group ( CG ) or treatment group ( TG ) , which received a 6-week exercise program with active exercise , muscle stretching and treadmill walking . The results obtained in trial 1 showed similar values for CG and TG , as both groups had muscle strength lower than normal patterns based on data concerning age , sex and weight . In trial 2 , CG and TG showed similarly decreased values . In trial 3 , TG showed values higher than CG for all muscle groups tested . These results suggest that the exercise program was efficient in promoting an increase of muscle strength after allogeneic BMT Background : The Healthy Exercise for Lymphoma Patients trial showed that aerobic exercise training improved important health outcomes in lymphoma patients . Here , we examine potential moderators of the exercise training response . Methods : Lymphoma patients were stratified by major disease type and current treatment status and r and omly assigned to usual care ( n = 62 ) or aerobic exercise training ( n = 60 ) for 12 weeks . Endpoints were quality of life , cardiovascular fitness , and body composition . Moderators were patient preference for group assignment , age , sex , marital status , disease stage , body mass index , and general health . Results : Patient preference did not statistically moderate the effects of exercise training on quality of life ( P for interaction = 0.36 ) , but the interaction effect of 7.8 points favoring patients with no preference was clinical ly meaningful . Marital status ( P for interaction = 0.083 ) , general health ( P for interaction = 0.012 ) , and body mass index ( P for interaction = 0.010 ) moderated the effects of aerobic exercise training on quality of life with better outcomes for unmarried versus married patients , patients in poor/fair health versus good-to-excellent health , and normal weight/obese versus overweight patients . Disease stage ( P for interaction = 0.056 ) and general health ( P for interaction = 0.012 ) moderated the effects of aerobic exercise training  on body composition with better outcomes for patients with advanced disease versus early disease/no disease and patients in good health versus very good-to-excellent health . No variables moderated intervention effects on cardiovascular fitness . Findings were not explained by differences in adherence . Conclusions : Clinical ly available variables predicted quality of life and body composition responses to aerobic exercise training in lymphoma patients . If replicated , these results may inform future r and omized trials and clinical practice . ( Cancer Epidemiol Biomarkers Prev 2009;18(10):2600–7 The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity ; one-repetition maximum ( 1RM ) and maximum oxygen uptake ( VO2Max ) , activity level , general well-being and quality of life in cancer patients undergoing chemotherapy .  The intervention comprised resistance and fitness training , massage , relaxation and body-awareness training .  Eighty-two cancer patients , with or without evidence of residual disease , were included : 66 patients with 13 different types of solid tumours and 16 patients with 6 types of haematological malignancies . The patients trained in mixed groups for 9 h weekly for 6 weeks . Physical capacity , physical activity level and psychosocial well-being as measured by the Medical Outcomes Study 36-item Short-Form Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Question naire C30 were assessed pre- and post-intervention . Highly significant increases were achieved in muscular strength ( p<0.001 ) , physical fitness ( p<0.001 ) and physical activity levels ( p<0.001 ) . The patients reported significant reduction in treatment-related symptoms , i.e. , fatigue ( p=0.006 ) and pain ( p=0.03 ) . Highly significant improvements were observed in physical functioning ( p<0.001 ) and role functioning ( p<0.001 ) . Even patients with advanced disease were able to improve their results after 6 weeks . It is concluded that a multidimensional exercise intervention , including resistance training , may be beneficial for cancer patients undergoing chemotherapy . This study indicates significant clinical meaningful improvements . The exact role of the intervention has to be defined in a r and omized controlled design . A clinical ly controlled trial including 250 patients is currently being carried out No published survey has specifically addressed the beliefs , knowledge , and usage of complementary and alternative medicine ( CAM ) in long‐term ( 5–20 years ) lymphoma survivors alone . In this pilot project , 95 subjects were r and omly selected from a population of 2,475 long‐term lymphoma survivors and mailed a question naire . The median time from lymphoma diagnosis to completion of the question naire was 11 years ( range 6–20 ) . Overall , 68 % ( 95 % CI : 54–80 % ) of the long‐term lymphoma survivors reported that they have used  CAM  , a rate higher than the estimated usage rate reported for the general population The most commonly used modalities were chiropractic ( 39 % , 95 % CI : 27–53 % ) and massage therapy ( 21 % , 95 % CI : 12–34 % ) . Less than 10 % used  meditation  ( 5 % , 95 % CI : 1–15 % ) and relaxation ( 7 % , 95 % CI : 2–17 % ) . In terms of common herbal usage , 5 % ( 95 % CI : 1–15 % ) had used St. John 's Wort and 7 % ( 95 % CI : 2–17 % ) had used shark cartilage . Although none of the patients reported that CAM usage was directed specifically towards treating their lymphoma , 4 % ( 95 % CI : 0–12 % ) of patients reported that CAM  could cure cancer , and 14 % ( 95 % CI : 6–26 % ) reported that CAM  could increase their feeling of control over their health . This pilot study suggests that long‐term lymphoma survivors appear to use CAM at a rate higher than the general population . The use of potential agents of risk by the survivors and the lack of access to potentially beneficial modalities highlights the need for further study of CAM in this population . Am . J. Hematol . , 2009 . © 2009 Wiley‐Liss , OBJECTIVES Restorative yoga ( RY ) is a gentle type of yoga that may be beneficial for cancer patients and post-treatment survivors . Study goals were : to determine the feasibility of implementing a RY intervention for women with breast cancer ; and to examine group differences in self-reported emotional , health-related quality of life , and symptom outcomes . METHODS Women with breast cancer ( n=44 ; mean age 55.8 years ) enrolled in this study ; 34 % were actively undergoing cancer treatment . Study participants were r and omized to the intervention ( 10 weekly 75-minute RY classes ) or a waitlist control group . Participants completed question naires at Week 0 ( baseline ) and Week 10 ( immediately post-intervention for the yoga group ) . RESULTS Group differences favoring the yoga group were seen for mental health , depression , positive affect , and spirituality ( peace/meaning ) . Significant baseline*group interactions were observed for negative affect and emotional well-being . Women with higher negative affect and lower emotional well-being at baseline derived greater benefit from the yoga intervention compared to those with similar values at baseline in the control group . The yoga group demonstrated a significant within-group improvement in fatigue ; no significant difference was noted for the control group . CONCLUSIONS Although limited by sample size , these pilot data suggest potential benefit of RY on emotional outcomes and fatigue in cancer patients . This study demonstrates that a RY intervention is feasible for women with breast cancer ; implication s for study design and implementation are noted with an emphasis on program adoption and participant adherence This report summarizes findings related to the psychometric properties ( internal consistency and construct validity ) of the Pittsburgh Sleep Quality Index ( PSQI ) and discusses issues related to its use based on data from two clinical studies with diverse sample s of cancer patients . Subjects completed a question naire that included the PSQI , the Schwartz Cancer Fatigue Scale , and specific demographic , disease , and treatment variables . There were complete data on 170 ( of 214 ) cases in Study 1 and 249 ( of 259 ) cases in Study 2 . The Cronbach 's alpha for the Global Sleep Quality scale was 0.81 in Study 1 and 0.77 in Study 2 A comparison of Global Sleep Quality in two contrasting groups with low and high fatigue yielded statistically significant differences in both sample s. Psychometric evaluation supports its internal consistency reliability and construct validity . However , the scoring is rather cumbersome and raises questions regarding level of measurement and appropriate analysis techniques Population -based studies on quality of life ( QOL ) of long-term breast cancer survivors are quite recent and insufficient attention has been paid to the effect of time since diagnosis . We compared long-term QOL of population -based breast cancer survivors 5 , 10 , and 15 years after diagnosis with that of healthy controls . Breast cancer survivors were r and omly selected from three population -based cancer registries ( Bas-Rhin , Calvados and Doubs , France ) along with healthy controls , stratified for age and place of residence , r and omly selected from electoral rolls . Participants completed five self-administered question naires : the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core 30 ( EORTC QLQ-C30 ) ,  Short Form-36 ( SF-36 ) , Spielberger State-Trait Anxiety Inventory ( STAI ) , Multidimensional Fatigue Inventory ( MFI ) and a  life conditions question naire . An analysis of variance was used to compare QOL scores of breast cancer survivors by period ( 5 , 10 , or 15 years ) of diagnosis with those of controls , adjusted for sociodemographic data and comorbidities . Six hundred and fifty-two cases and 1,188 controls participated in the study . For many QOL scales , scores were significantly different between cancer survivors and controls . A clinical ly significant difference was evidence d for the fatigue scales , the SF36 physical functioning , role-physical , and role-emotional scales , with more favorable results for controls . Differences decreased with time and 15-year cancer survivors were generally not different from controls . Scores were particularly influenced by age and mean household income . More efforts should be made , specifically during the first 5 to 10 years after diagnosis , to help women with breast cancer to overcome their impairment in QOL Purpose : To examine the effect of regular Iyengar yoga practice on measures of self‐perceived psychosocial function and diurnal salivary cortisol secretion in stage II – IV breast cancer survivors ( n = 18 ) . Data sources : Women were r and omly assigned to attend yoga practice for 90 min twice weekly for 8 weeks ( n = 9 ) or to a wait‐listed , noninterventional control group ( n = 9 ) . Traditional Iyengar yoga routines that progressively increased in difficulty as participants gained strength and flexibility were used . At baseline and after the 8‐week study period , women completed self‐report instruments to document various aspects of psychosocial and physical functioning , and collected salivary sample s for cortisol analysis four times during the day for two consecutive days . Conclusions : The yoga group had lower morning and 5 p.m. salivary cortisol and improved emotional well‐being and fatigue scores . Implication s for practice : Breast cancer survivors are at risk for chronic psychosocial distress that may alter activity of the hypothalamic – pituitary – adrenal axis , result ing in aberrant regulation of cortisol secretion and increased risk of immune dysfunction and cancer progression . Regular yoga practice may be a low‐risk , cost‐effective way to improve psychosocial functioning , fatigue , and regulation of cortisol secretion in breast cancer survivors . These findings require validation with a larger r and omized study BACKGROUND : Children undergoing stem cell transplantation ( SCT ) are thought to be at risk for increased distress , adjustment difficulties , and impaired health-related quality of life ( HRQL ) . We report results of a multisite trial design ed to improve psychological adjustment and HRQL in children undergoing SCT . METHODS : A total of 171 patients and parents from 4 sites were r and omized to receive a child-targeted intervention ; a child and parent intervention ; or st and ard care . The child intervention included massage and humor therapy ; the parent intervention included massage and relaxation/imagery . Outcomes included symptoms of depression and posttraumatic stress , HRQL , and benefit finding . Assessment s were conducted by patient and parent report at admission and SCT week+24 . RESULTS : Across the sample , significant improvements were seen on all outcomes from admission to week+24 . Surprisingly , patients who had SCT reported low levels of adjustment difficulties at admission , and improved to normative or better than average levels of adjustment and HRQL at week+24 . Benefit finding was high at admission and increased at week+24 ; however , there were no statistically significant differences between intervention arms for any of the measures . CONCLUSIONS : Although the results do not support the benefits of these complementary interventions in pediatric SCT , this may be explained by the remarkably positive overall adjustment seen in this sample . Improvements in supportive care , and a tendency for patients to find benefit in the SCT experience , serve to promote positive outcomes in children undergoing this procedure , who appear particularly resilient to the challenge PURPOSE To evaluate the effectiveness of a supervised home-based flexible training program on cardiorespiratory fitness ( CRF ) , mental distress , and health-related quality of life ( HRQOL ) parameters in young and middle-aged cancer patients shortly after curative chemotherapy . PATIENTS AND METHODS One hundred eleven patients age 18 to 50 years who had received chemotherapy for lymphomas or breast , gynecologic , or testicular cancer completed the trial . These patients were r and omly allocated to either an intervention group ( n = 59 ) , which underwent a 14-week training program , or a control group ( n = 52 ) that received st and ard care . Primary outcome was change in CRF , as determined by Astr and -Rhyming indirect bicycle ergometer test ( maximum oxygen uptake [ VO(2max ) ] ) , between baseline ( T0 ) and follow-up ( T1 ) . Secondary outcomes were mental distress , as assessed by the Hospital Anxiety and Depression Scale , and HRQOL , as assessed by the European Organisation for Research and Treatment of Cancer Core Quality of Life Question naire . Two-way analysis of covariance was used to analyze changes from T0 to T1 . RESULTS VO(2max ) increased by 6.4 mL/kg(-1)/min(-1 ) in patients in the intervention group and by 3.1 mL/kg(-1)/min(-1 ) in patients in the control group ( P < .01 ) . The fatigue score decreased by 17.0 points in the control group compared with only 5.8 points in the intervention group ( P < .01 ) . There were no intergroup differences in mental distress or HRQOL . CONCLUSION A supervised , home-based , flexible training program has significant effect on CRF in young and middle-aged cancer patients shortly after curative chemotherapy , but it has no favorable effect on patients ' experience of fatigue , mental distress , or HRQOL Background Altered nutrient intake and decreased exercise in response to cancer therapies and their side effects , particularly corticosteroids , may be key factors in the increased body weight and differences in physical fitness reported in survivors of childhood acute lymphoblastic leukemia ( ALL ) . Purpose To assess ( 1 ) the effect of a home-based nutrition and exercise intervention program on cardiovascular fitness , strength , and flexibility in children with ALL during maintenance therapy and ( 2 ) the feasibility of conducting and evaluating a home-based exercise and nutrition program in this patient population . Design Children ages 4 to 10 years with st and ard-risk ALL were r and omized when starting maintenance therapy to a 12-month home-based exercise and nutrition program ( n=6 , 3 males/3 females ) or control ( n=7 , 4 males/3 females ) group . Assessment of anthropometrics , dietary intake , physical activity , and fitness was performed at baseline and 6 and 12 months of study . Results Although age , body size , and nutrient intakes were similar between both subject groups at 0 , 6 , and 12 months , exercise and nutrition program children had greater improvement in physical activity and cardiovascular fitness between 6 and 12 months than control children . Conclusions These results suggest that a home-based exercise intervention during maintenance therapy encouraged greater physical activity and improved cardiovascular fitness in children with st and ard-risk ALL . Further investigation involving larger population s of children with ALL is warranted OBJECTIVES This study compares the anxiolytic effects of a yoga program and supportive therapy in breast cancer out patients undergoing conventional treatment at a cancer centre . METHODS Ninety-eight stage II and III breast cancer out patients were r and omly assigned to receive yoga ( n=45 ) or brief supportive therapy ( n=53 ) prior to their primary treatment i.e. , surgery . Only those subjects who received surgery followed by adjuvant radiotherapy and six cycles of chemotherapy were chosen for analysis following intervention ( yoga , n=18 , control , n=20 ) . Intervention consisted of yoga sessions lasting 60min daily while the control group was imparted supportive therapy during their hospital visits as a part of routine care . Assessment s included Speilberger 's State Trait Anxiety Inventory and symptom checklist . Assessment s were done at baseline , after surgery , before , during , and after radiotherapy and chemotherapy . RESULTS A GLM-repeated measures ANOVA showed overall decrease in both self-reported state anxiety ( p<0.001 ) and trait anxiety ( p=0.005 ) in yoga group as compared to controls . There was a positive correlation between anxiety states and traits with symptom severity and distress during conventional treatment intervals . CONCLUSION The results suggest that yoga can be used for managing treatment-related symptoms and anxiety in breast cancer out patients 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 r and omized controlled clinical trial comparing pranayama to usual care . SETTING The study was conducted at a university medical center . SUBJECTS Patients receiving cancer chemotherapy were r and omized 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 practice d 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 practice d in class or at home , result ed 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 The present prospect i ve study aim ed at ( 1 ) investigating the frequency of high levels of psychological distress in women with early-stage breast cancer almost two years after diagnosis and ( 2 ) identifying characteristics associated with long-term distress . One hundred and seventy women participated on two occasions . Two months after surgery , patients completed question naires measuring psychosocial variables ( e.g. , stressful life-events , health complaints , sleep problems , social support , subjective distress , personality factors ) , demographic and biomedical variables ( e.g. , TNM status , type of surgery ) . At the second measurement , subjective distress was assessed for a second time by means of the Impact of Events Scale ( IES ) . Almost two years after diagnosis , 16 % of the women reported a high level of psychological distress as measured by the Intrusion scale ( IES ) . Best predictors of a high level of distress were : intrusive thoughts about the disease , trait-anxiety , health complaints and problems with sleeping . No significant association was found between previous life-events , social support or biomedical variables and levels of distress OBJECTIVES Individuals with asthma frequently suffer with a decrease in quality of life .  Yoga has been shown to improve autonomic function in the healthy population and has been used as an alternative therapy to help improve symptoms associated with various diseases . PURPOSE The purpose of this study was to assess whether 10 weeks of yoga training can improve quality of life and heart rate variability ( HRV ) in patients with asthma . DESIGN Nineteen ( 19 ) females were r and omly assigned to a yoga group or a control group for a 10-week intervention while still following guidelines established by their physician . All subjects answered the St. George 's Respiratory Question naire ( SGRQ ) to assess quality of life and performed an isometric h and grip exercise test to assess HRV . RESULTS Based on the SGRQ , significant improvements ( 45 % , p < 0.05 ) in quality of life were observed with the yoga training , while no changes were found in the control group . Resting hemodynamic measures improved significantly in the yoga group compared to the control group ( p < 0.05 ) . The yoga group decreased parasympathetic modulation ( HFnu [ normalized units ] ) pre- to postintervention ( 0.45 ± 0.60 to 0.35 ± 0.06 nu , p<0.05 , respectively ) in response to the isometric forearm exercise ( IFE ) , whereas the control group did not change . Additionally , the yoga group increased sympathetic ( LFnu ) ( pre 0.47 ± 0.07 to post 0.60 ± 0.07 nu , p < 0.05 ) and sympathovagal modulation ( logLF/HF ) ( pre 4.61 ± 0.39 to post 5.31 ± 0.44 , p < 0.05 , respectively ) during IFE with no change in the control group . CONCLUSIONS Yoga training improved quality of life  in women with mild-to-moderate asthma and result ed in decreased parasympathetic and increased sympathetic modulation in response to an IFE Feasibility studies of complementary therapies are useful and important not only to test and evaluate the potential effectiveness of an intervention but also to refine and improve it prior to a subsequent study . A series of guided interviews were conducted with patients ( n=19 ) undergoing stem cell/autologous bone marrow transplant ( SC/ABMT ) who were participating in a feasibility study of a mindfulness meditation ( MM ) intervention .  Audiotapes of these interview sessions were transcribed and then used to create a project in the QRS NVivo software program to manage the data from the interview questions . Responses about what the participants liked and disliked and their suggestions for improving the effectiveness of the  MM intervention  were identified and grouped . Subsequently , the MM intervention has been refined based on this information , and additional testing in a r and omized , controlled trial is planned . The cost is high to implement complementary therapies and to rigorously test them . Preliminary work using qualitative evaluation methods can provide rich and detailed information that will save time and money in the long run 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 r and omly 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 r and om 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
BACKGROUND Haematological malignancies are malignant neoplasms of the myeloid or lymphatic cell lines including leukaemia , lymphoma and myeloma .
In order to manage physical and psychological aspects of the disease and its treatment , complementary therapies like yoga are coming increasingly into focus .
However , the effectiveness of yoga practice for people suffering from haematological malignancies remains unclear .
OBJECTIVES To assess the effects of yoga practice in addition to st and ard cancer treatment for people with haematological malignancies .