Improve the Ability of Yoga to Reduce Fatigue in Cancer Patients with Email Reminders
By John M. de Castro, Ph.D.
“Yoga works on the principle of mind and body health and it would help women cope with systemic therapy side effects better. Yoga nidra and pranayama also improve sleep patterns. Thus all this together may reduce fatigue and pain.” – Nita Nair
Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.
Mindfulness training has been shown to help with general cancer recovery. Mindfulness practices have been shown to improve the residual symptoms in cancer survivors. Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. But adherence to practice over time can be a problem with yoga. So, it is important to investigate methods to improve long-term adherence to yoga practice to enhance and maintain its benefits for cancer survivors.
In today’s Research News article “Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550207/ ) Zetzl and colleagues recruited adult cancer survivors who reported fatigue symptoms and provided them with an 8 weekly 1-hour sessions of yoga practice. They were randomly assigned to no further treatment or to receive email reminders and a description of a yoga posture and encouragement to practice once a week for 24 weeks following the completion of training. They were measured before and after the yoga therapy and 6 months later for fatigue, frequency of yoga practice, depression, and quality of life.
They found that in comparison to baseline yoga therapy produced significant reductions in fatigue and depression and significant increases in quality of life, These improvements were maintained 6 months later. In addition, the group that received email reminders compared to the no email reminder group at the 6-month follow-up had greater reductions in fatigue particularly emotional fatigue and they practiced more frequently. A mediation analysis revealed that email reminders were related to reductions in emotional fatigue directly and also indirectly by increasing practice frequency which in turn also decreased fatigue.
The study demonstrates that yoga practice by cancer survivors improves their quality of life and reduces depression and fatigue. These findings are not new as yoga practice has been reported by other researchers in a variety of participant types to improve quality of life and reduce depression and fatigue. What is new here is the demonstration that these benefits for cancer survivors can be increased by providing weekly email reminders to practice yoga to increase the frequency of practice.
So, improve the ability of yoga to reduce fatigue in cancer patients with email reminders.
“yoga may be beneficial as a component of treatment for both fatigue and depression in cancer survivors.” – Jessica Armer
CMCS – Center for Mindfulness and Contemplative Studies
This and other Contemplative Studies posts are available on Twitter @MindfulResearch
Study Summary
Zetzl, T., Pittig, A., Renner, A., van Oorschot, B., & Jentschke, E. (2021). Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 29(12), 7725–7735. https://doi.org/10.1007/s00520-021-06345-z
Abstract
Objective
To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life.
Methodology
One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2).
Result
A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B = − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54).
Conclusion
Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8550207/