Pediatric cancer patients experience symptoms that negatively impact quality of life; yoga may be an effective intervention. The primary objective was to determine the feasibility of a 10-week, weekly individualized yoga intervention for children and adolescents receiving outpatient cancer therapy primarily delivered remotely using Skype. Secondary objectives were to describe depression, anxiety, anger, fatigue, quality of life, and symptoms at 5 and 10 weeks after enrollment.
We included English-speaking patients aged 10 to 18 years receiving outpatient chemotherapy for cancer. Weekly individualized yoga sessions were offered for 10 weeks. Weeks 1, 5, and 10 were in-hospital while the remaining sessions were delivered remotely using Skype. Twice weekly, homework was assigned between each session. The primary outcome was feasibility, defined as 80% of participants completing at least 60% of planned in-hospital or remote yoga sessions.
Between March and November 2017, 10 patients were enrolled. Two patients discontinued the study after one and two sessions. Only six participants achieved at least 60% of planned yoga sessions and thus, the study did not meet the a priori defined feasibility threshold. Among all participants, only one homework session was performed.
A 10-week individualized in-person and remotely conducted yoga intervention was not feasible in children receiving cancer treatments because of failure to achieve the desired frequency of yoga sessions in a sufficient number of participants. Future research should identify approaches to improve compliance with remote yoga sessions and home practice.
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the Patient-Reported Outcomes Measurement Information System
Pediatric Quality of Life
Multidimensional Fatigue Scale
Symptom Screening in Pediatrics Tool
Research Electronic Data Capture
Statistical Analysis Software
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We wish to thank the volunteer yoga instructors, Robin Hurlow and Jeff Goodman, for sharing their time and expertise with the participants involved in this study.
Funding from this study was provided by the Pediatric Oncology Group of Ontario (POGO) Seed Funding Grant.
Research Ethics Board approval was obtained from SickKids (REB#1000054681). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflicts of interest
There are no financial or non-financial conflicts of interest for any of the authors involved in this study.
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Eliana Stein and Meera Rayar are co-first authors.
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Stein, E., Rayar, M., Krishnadev, U. et al. A feasibility study examining the impact of yoga on psychosocial health and symptoms in pediatric outpatients receiving chemotherapy. Support Care Cancer 27, 3769–3776 (2019). https://doi.org/10.1007/s00520-019-04673-9
- Pediatric oncology
- Yoga therapy