Yoga for chronic chemotherapy-induced peripheral neuropathy pain: a pilot, randomized controlled trial

Robert Knoerl, Anita Giobbie-Hurder, Juliana Berfield, Donna Berry, Jeffrey A Meyerhardt, Alexi A Wright, Jennifer A Ligibel, Robert Knoerl, Anita Giobbie-Hurder, Juliana Berfield, Donna Berry, Jeffrey A Meyerhardt, Alexi A Wright, Jennifer A Ligibel

Abstract

Purpose: To determine the feasibility of implementing a yoga intervention for cancer survivors with chronic CIPN pain, as well as the impact of the intervention on patient-reported outcomes.

Methods: Cancer survivors with chronic CIPN pain were recruited from the breast, gastrointestinal, and gynecological oncology centers at Dana-Farber Cancer Institute. Participants were randomized (2:1) to receive an 8-week yoga intervention or usual care. After 21/50 of participants were enrolled, the COVID-19 pandemic required the yoga intervention to be delivered virtually (i.e., Zoom). Pre- and post-intervention, participants self-reported CIPN and co-occurring symptom severity. Adherence to the intervention was defined as practicing ≥ 12 yoga sessions over the 8-week intervention period. Changes in patient-reported outcomes between groups were compared using Wilcoxon's rank-sum tests.

Results: Participants (n = 28 yoga, n = 16 control) were mainly female (96%) and diagnosed with stage III/IV disease (66%). Overall, 19/28 (67.8%) of yoga group participants were adherent to the yoga protocol. Yoga group participants experienced significant within-group improvements in all patient-reported outcomes, including worst CIPN pain (median change = - 1.7, p < 0.0001) and sensory CIPN (median change = - 14.8, p < 0.0001), but only improvements in fatigue (p = 0.05) and depression (p = 0.04) were significant compared to the control. There were no differences (p > 0.05) in changes in patient-reported outcomes between in-person (n = 6) or virtual (n = 15) yoga group participants.

Conclusions: Yoga is a feasible non-pharmacological modality for cancer survivors with CIPN, but more information is needed regarding its impact on CIPN and other symptoms.

Trial registration: ClinicalTrials.gov Identifier: NCT03824860 IMPLICATIONS FOR CANCER SURVIVORS: Oncology clinicians may consider referring cancer survivors to yoga for chronic CIPN pain, but yoga cannot be currently recommended as an efficacious treatment.

Keywords: Cancer survivors; Chemotherapy-induced peripheral neuropathy; Integrative oncology; Neoplasms; Randomized controlled trial [publication type]; Yoga.

Conflict of interest statement

RK has received personal fees (consulting) from Strategy Inc, Spark Healthcare, and System Analytic; and serves on the scientific advisory board of Wellium. JM has received institutional research funding from Boston Biomedical, has served as an advisor/consultant to COTA Healthcare, and has served on a grant review panel for the National Comprehensive Cancer Network funded by Taiho Pharmaceutical.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Figures

Fig. 1
Fig. 1
Consort flow diagram. The figure describes yoga and control group participants’ progress through the study

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