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Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research.

ABSTRACT: BACKGROUND:Myeloproliferative neoplasm (MPN) patients suffer from significant symptoms, inflammation and reduced quality of life. Yoga improves these outcomes in other cancers, but this hasn't been demonstrated in MPNs. The purpose of this study was to: (1) explore the limited efficacy (does the program show promise of success) of a 12-week online yoga intervention among MPN patients on symptom burden and quality of life and (2) determine feasibility (practicality: to what extent a measure can be carried out) of remotely collecting inflammatory biomarkers. METHODS:Patients were recruited nationally and randomized to online yoga (60?min/week of yoga) or wait-list control (asked to maintain normal activity). Weekly yoga minutes were collected with Clicky (online web analytics tool) and self-report. Those in online yoga completed a blood draw at baseline and week 12 to assess inflammation (interleukin-6, tumor necrosis factor-alpha [TNF-?]). All participants completed questionnaires assessing depression, anxiety, fatigue, pain, sleep disturbance, sexual function, total symptom burden, global health, and quality of life at baseline, week seven, 12, and 16. Change from baseline at each time point was computed by group and effect sizes were calculated. Pre-post intervention change in inflammation for the yoga group was compared by t-test. RESULTS:Sixty-two MPN patients enrolled and 48 completed the intervention (online yoga?=?27; control group?=?21). Yoga participation averaged 40.8?min/week via Clicky and 56.1?min/week via self-report. Small/moderate effect sizes were generated from the yoga intervention for sleep disturbance (d?=?-?0.26 to -?0.61), pain intensity (d?=?-?0.34 to -?0.51), anxiety (d?=?-?0.27 to -?0.37), and depression (d?=?-?0.53 to -?0.78). A total of 92.6 and 70.4% of online yoga participants completed the blood draw at baseline and week 12, respectively, and there was a decrease in TNF-? from baseline to week 12 (-?1.3?±?1.5?pg/ml). CONCLUSIONS:Online yoga demonstrated small effects on sleep, pain, and anxiety as well as a moderate effect on depression. Remote blood draw procedures are feasible and the effect size of the intervention on TNF-? was large. Future fully powered randomized controlled trials are needed to test for efficacy. TRIAL REGISTRATION:This trial was retrospectively registered with clinicaltrials.gov (ID: NCT03503838 ) on 4/19/2018.

SUBMITTER: Huberty J

PROVIDER: S-EPMC6556039 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research.

Huberty Jennifer J Eckert Ryan R Dueck Amylou A Kosiorek Heidi H Larkey Linda L Gowin Krisstina K Mesa Ruben R

BMC complementary and alternative medicine 20190607 1

<h4>Background</h4>Myeloproliferative neoplasm (MPN) patients suffer from significant symptoms, inflammation and reduced quality of life. Yoga improves these outcomes in other cancers, but this hasn't been demonstrated in MPNs. The purpose of this study was to: (1) explore the limited efficacy (does the program show promise of success) of a 12-week online yoga intervention among MPN patients on symptom burden and quality of life and (2) determine feasibility (practicality: to what extent a measu ...[more]

PMID: 31174535

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Project description:BackgroundMyeloproliferative neoplasm (MPN) patients often report high symptom burden that persists despite the best available pharmacologic therapy. Meditation has gained popularity in recent decades as a way to manage cancer patient symptoms.ObjectiveThe aim of this study was to examine the feasibility of 2 different consumer-based meditation smartphone apps in MPN patients and to examine the limited efficacy of smartphone-based meditation on symptoms compared with an educational control group.MethodsPatients (n=128) were recruited nationally through organizational partners and social media. Eligible and consented patients were enrolled into 1 of 4 groups, 2 of which received varying orders of 2 consumer-based apps (10% Happier and Calm) and 2 that received one of the apps alone for the second 4 weeks of the 8-week intervention after an educational control condition. Participants were asked to perform 10 min of meditation per day irrespective of the app and the order in which they received the apps. Feasibility outcomes were measured at weeks 5 and 9 with a Web-based survey. Feasibility outcomes were acceptability, demand, and limited efficacy for depression, anxiety, pain intensity, sleep disturbance, sexual function, quality of life, global health, and total symptom burden.ResultsA total of 128 patients were enrolled across all 4 groups, with 73.4% (94/128) patients completing the intervention. Of the participants who completed the 10% Happier app, 61% (46/76) enjoyed it, 66% (50/76) were satisfied with the content, and 77% (59/76) would recommend to others. Of those who completed the Calm app, 83% (56/68) enjoyed it, 84% (57/68) were satisfied with the content, and 97% (66/68) would recommend to others. Of those who completed the educational control, 91% (56/61) read it, 87% (53/61) enjoyed it, and 71% (43/61) learned something. Participants who completed the 10% Happier app averaged 31 (SD 33) min/week; patients completing the Calm app averaged 71 (SD 74) min/week. 10% Happier app participants saw small effects on anxiety (P<.001 d=-0.43), depression (P=.02; d=-0.38), sleep disturbance (P=.01; d=-0.40), total symptom burden (P=.13; d=-0.27), and fatigue (P=.06; d=-0.30), and moderate effects on physical health (P<.001; d=0.52). Calm app participants saw small effects on anxiety (P=.29; d=-0.22), depression (P=.09; d=-0.29), sleep disturbance (P=.002; d=-0.47), physical health (P=.005; d=0.44), total symptom burden (P=.13; d=-0.27), and fatigue (P=.13; d=-0.27). Educational control participants (n=61) did not have effects on any patient-reported outcome except for a moderate effect on physical health (P<.001; d=0.77).ConclusionsDelivering meditation via the Calm app is feasible and scored higher in terms of feasibility when compared with the 10% Happier app. The Calm app will be used to implement a randomized controlled trial, testing the effects of meditation on symptom burden in MPNs.Trial registrationClinicalTrials.gov NCT03726944; https://clinicaltrials.gov/ct2/show/NCT03726944 (Archived by WebCite at http://www.webcitation.org/77MVdFJwM).

Project description: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.A pilot study was performed to evaluate feasibility and to test the effects of pranayama on cancer-associated symptoms and quality of life.This was a randomized controlled clinical trial comparing pranayama to usual care.The study was conducted at a university medical center.Patients receiving cancer chemotherapy were randomized to receive pranayama immediately or after a waiting period (control group).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.Feasibility, cancer-associated symptoms (fatigue, sleep disturbance, anxiety, depression, stress), and quality of life were the outcomes.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.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.

Project description:Although research has demonstrated the benefits of yoga to people who have been diagnosed with diabetes or at risk of diabetes, studies have not confirmed these effects can be ascribed to the specific features of the traditional postures, called asanas. Instead, the effects of asanas could be ascribed to the increase in cardiovascular activity and expenditure of energy or to the expectation of health benefits. Therefore, to establish whether asanas are beneficial, researchers need to design a control condition in which participants complete activities, called sham poses, that are equivalent to traditional asanas in physical activity and expectation of benefits. The aim of this research was to design an appropriate suite of sham poses and to demonstrate these poses and traditional asanas are equivalent in energy expenditure, cardiovascular response, and expectations of health benefits. Twenty healthy men at medium to high risk of developing diabetes volunteered to partake in the current study. These men completed two sessions that comprised traditional asanas and two sessions that comprised sham poses-poses that utilize the same muscle groups as the asanas and were assigned fictitious Sanskrit labels. Before and after each session, heart rate, blood pressure, blood glucose levels, triglycerides levels, and oxygen saturation were measured to gauge the intensity of exercise. After each session, using a standard measure, participants also indicated the degree to which they expected the poses to improve health. The degree to which the sessions affected the physiological measures (for example, pre-exercise, the heart rate for yoga and sham was 71.06 ± 4.79 and 73.88 ± 6.05, respectively, and post-exercise, the heart rate was 70.19 ± 6.16 and 73 ± 7.55, respectively) and the expectations of health improvements did not differ between the traditional asanas and the sham poses. Likewise, the degree to which each session influenced these physiological measures was negligible in both conditions. This study developed a series of poses that elicit similar physiological and psychological effect as traditional yoga asanas. These poses can be used in an active control group in future randomized trial studies that are designed to assess the benefits of asanas.

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Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research.

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Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research.

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