Yoga for cancer survivors with chemotherapy-induced peripheral neuropathy: Health-related quality of life outcomes

W Iris Zhi, Raymond E Baser, Lillian M Zhi, Dristi Talukder, Qing S Li, Tina Paul, Clare Patterson, Lauren Piulson, Christina Seluzicki, Mary L Galantino, Ting Bao, W Iris Zhi, Raymond E Baser, Lillian M Zhi, Dristi Talukder, Qing S Li, Tina Paul, Clare Patterson, Lauren Piulson, Christina Seluzicki, Mary L Galantino, Ting Bao

Abstract

Background: Yoga is a meditative movement therapy focused on mind-body awareness. The impact of yoga on health-related quality of life (HRQOL) outcomes in patients with chemotherapy-induced peripheral neuropathy (CIPN) is unclear.

Methods: We conducted a pilot randomized wait-list controlled trial of 8 weeks of yoga (n = 21) versus wait-list control (n = 20) for CIPN in 41 breast and gynecological cancer survivors with persistent moderate to severe CIPN. HRQOL endpoints were Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI), and Insomnia Severity Index (ISI). The Treatment Expectancy Scale (TES) was administered at baseline. We estimated mean changes and 95% confidence intervals (CIs) from baseline to weeks 8 and 12 and compared arms using constrained linear mixed models.

Results: At week 8, HADS anxiety scores decreased -1.61 (-2.75, -0.46) in the yoga arm and -0.32 (-1.38, 0.75) points in the wait-list control arm (p = 0.099). At week 12, HADS anxiety scores decreased -1.42 (-2.57, -0.28) in yoga compared to an increase of 0.46 (-0.60, 1.53) in wait-list control (p = 0.017). There were no significant differences in HADS depression, BFI, or ISI scores between yoga and wait-list control. Baseline TES was significantly higher in yoga than in wait-list control (14.9 vs. 12.7, p = 0.019). TES was not associated with HADS anxiety reduction and HADS anxiety reduction was not associated with CIPN pain reduction.

Conclusions: Yoga may reduce anxiety in patients with CIPN. Future studies are needed to confirm these findings.

Clinical trial registration number: ClinicalTrials.gov Identifier: NCT03292328.

Keywords: QOL; breast cancer; chemotherapy; clinical cancer research; gynecological oncology; quality of life.

Conflict of interest statement

All authors declare no conflicts of interest. We certify that there are no affiliations with or involvement in any organization or entity with any financial interest or other equity interests or non‐financial interests that influenced the design, outcome, and submission of this study.

© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Health‐related quality of life outcome changes by week and treatment arm. Data points represent the model‐estimated means and 95% confidence intervals (indicated by the I bars) from a constrained linear mixed model (cLMM) with baseline means constrained to be equal across study arms, reflecting the pre‐randomization nature of the baseline assessment. See Methods section for model details. A, HADS Anxiety subscale ranges from 0 to 21, with higher scores indicating higher anxiety symptoms. B, HADS Depression subscale ranges from 0 to 21, with higher scores indicating higher depressive symptoms. C, ISI Total score ranges from 0 to 28, with higher scoring indicating higher insomnia symptoms. D, BFI Total score ranges from 0 to 10, with higher scores indicating higher fatigue. Abbreviations: BFI, Brief Fatigue Inventory; CI, confidence interval; HADS, Hospital Anxiety and Depression Scale; ISI, Insomnia Severity Index; WLC, wait‐list control

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