Different Aspects of Yoga Practice Affect the Psychological Benefits

Different Aspects of Yoga Practice Affect the Psychological Benefits

 

By John M. de Castro, Ph.D.

 

“Most styles of yoga are based on the same basic yoga poses (called asanas), however the experience of one style can be radically different than another.” – DoYoga

 

Yoga training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. But there are a wide variety of different yoga training techniques and practices. Although the benefits of yoga practices in general are well studied there is little scientific research comparing different components of yoga practices and the benefits.

 

In today’s Research News article “Exploring how different types of yoga change psychological resources and emotional well-being across a single session.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081324/ ) Park and colleagues recruited adults who had attended at least 5 yoga classes. There were 3 different practice sites engaged in a variety of types of yoga; Hatha yoga: Ashtanga, Baptiste, Bikram, Forrest, Iyengar, Kripalu, Kundalini, Pranayama, Restorative, Vinyasa Flow, and Yin. Before and after a 60-minute yoga class they were measured for psychological resources (mindfulness, body awareness, self-transcendence, peacefulness and contentment, social connectedness), and exercise induced feelings (positive emotions, revitalization, tranquility, and exhaustion). After the class they were measured for properties of yoga, physical taxation, and therapist warmth.

 

In comparison to before the yoga class, afterward there were significant increases exercise induced feelings (positive emotions, revitalization, tranquility, and decreased exhaustion), psychological resources (mindfulness, body awareness, self-transcendence, spirituality, and social connectedness). In addition, the greater the increase in positive emotions, revitalization, and tranquility, the greater the increase in mindfulness, self-transcendence, spirituality, and social connectedness. In addition, the greater the decrease in exhaustion the greater the increase in mindfulness, self-transcendence, spirituality, and social connectedness.

 

They also investigated different aspects of the yoga practice and their relationships to psychological resources and emotions. They found that the higher the levels of the restorative aspects of the yoga practice the greater the changes in self-transcendence, spirituality, and tranquility, the higher the levels of the breathwork aspects of the yoga practice the greater the changes in body awareness and self-transcendence, and the higher the levels of the therapist warmth the greater the changes in self-transcendence and positive engagement.

 

These results are correlative and need to be interpreted with caution. But they provide interesting clues as to how yoga practice may produce some of its benefits. It increases the psychological resources available to the participants and improves their emotions. They also showed that the larger the increases in psychological resources produced by yoga practice the greater the improvements in emotions. Finally, they showed that restorative and breathwork aspects of yoga practice and the therapist warmth were most related to improvements.

 

Much more research is needed. But this study suggests that yoga practice strengthens the psychological resources of the practitioners and these are related to improved emotions. It also demonstrates that certain aspects of yoga practice that are differently emphasized in different styles of yoga, particularly restorative and breathwork aspects of yoga practice and the therapist warmth, may contribute to yoga’s benefits.

 

So, different aspects of yoga practice affect the psychological benefits.

 

figure out your intention—do you want to do yoga to improve your health; lessen stress; increase mindfulness; gain strength; lose weight or relieve pain? Once you have the answer to this question you will know the practice that is right for you.” – Femina

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Park, C. L., Finkelstein-Fox, L., Groessl, E. J., Elwy, A. R., & Lee, S. Y. (2020). Exploring how different types of yoga change psychological resources and emotional well-being across a single session. Complementary therapies in medicine, 49, 102354. https://doi.org/10.1016/j.ctim.2020.102354

 

Abstract

Objectives:

Yoga demonstrates beneficial effects in many populations, yet our understanding of how yoga brings about these effects is quite limited. Among the proposed mechanisms of yoga are increasing psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) that may bring about salutary effects on emotional wellbeing. Further, yoga is a complex practice comprising meditation, active and restorative postures, and breathwork; however little is known about how different components may affect mechanisms. We aimed to determine how an acute session of yoga (and its specific components) related to pre- to post- session changes in proposed mechanisms (psychological resources) and whether those changes were associated with positive changes in emotions.

Design:

144 regular yoga practitioners completed measures of mindfulness, body consciousness, self-transcendence, social connectedness, spiritual peace, and exercise-induced emotions (positive engagement, revitalization, tranquility, exhaustion) immediately before and after a yoga session (N=11 sessions, each a different type of yoga). Perceived properties of each yoga session, exercise exertion and engagement with the yoga teacher were assessed immediately following the session.

Results:

Pre- to post- yoga, levels of positive emotions (engagement, tranquility and revitalization) increased while exhaustion decreased. Further, all psychological resources increased and closely tracked improved emotions. Additionally, aspects of the yoga session correlated with changes in psychological resources (mechanisms) and emotions.

Conclusions:

Yoga may influence multiple psychological mechanisms that influence emotional well-being. Further, different types of yoga may affect different mechanisms. Results can inform yoga interventions aiming to optimize effects through specific mechanisms such as mindfulness or spirituality.

Highlights

  • To gain a better understanding of how yoga brings about beneficial effects, we examined changes in psychological resources and emotions across a single session of yoga.
  • All five psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) increased from pre-to-post yoga session, and all emotions (positive engagement, revitalization, tranquility and exhaustion) improved.
  • Further, improvements in emotions were associated with improvements in psychological resources.
  • Different styles of yoga were associated with differential improvements in psychological resources and emotions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081324/

 

Improve Sleep in People with Sleep Disturbance with a Meditation App

Improve Sleep in People with Sleep Disturbance with a Meditation App

 

By John M. de Castro, Ph.D.

 

“Sufficient sleep heals our bodies and minds, but for many reasons sleep doesn’t always come easily. Mindfulness practices and habits can help us fall asleep and stay asleep.” – Mindful

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness.

 

Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many patients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these Apps in improving sleep in patients with sleep disturbance.

 

In today’s Research News article “Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790277/ ) Huberty and colleagues recruited online, adults with moderate sleep disorder, insomnia, and randomly assigned them to a wait-list control condition or to use the “Calm” meditation app for 10 minutes per day for 8 weeks. They were measured before, during, and after for fatigue, daytime sleepiness, pre-sleep arousal, sleep quality, and use of the app.

 

They found that there was high adherence to app use, with an average of 6.36 uses per week that remained steady over the 8-week intervention period. They found that in comparison to baseline and the wait-list control group, the group that used the “Calm” app had greater reductions in fatigue, daytime sleepiness, and cognitive and somatic pre-sleep arousal. In addition, the group that used the “Calm” app had significant improvements in sleep quality, including falling asleep faster and sleeping longer.

 

The results of this study suggest that using the “Calm” app improves the sleep of individuals with insomnia and also reduces daytime fatigue and sleepiness, and pre-sleep arousal. The results of this study suggest that using the “Calm” app improves the sleep of individuals with insomnia and also reduces daytime fatigue and sleepiness, and pre-sleep arousal. The results are not surprising as mindfulness training has been shown repeatedly to improve sleep and reduce fatigue. But demonstrating these improvements with an app that is widely available, inexpensive, and convenient to use, is important as the app makes treatment more readily available for a wider group of patients. Hence, the Calm” app would seem to be an excellent treatment for the moderate sleep disorder of insomnia.

 

So, improve sleep in people with sleep disturbance with a meditation app.

 

The idea is to create a reflex to more easily bring forth a sense of relaxation. That way, it’s easier to evoke the relaxation response at night when you can’t sleep. In fact, the relaxation response is so, well, relaxing that your daytime practice should be done sitting up or moving (as in yoga or tai chi) so as to avoid nodding off.” – Julie Corliss

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Huberty, J. L., Green, J., Puzia, M. E., Larkey, L., Laird, B., Vranceanu, A. M., Vlisides-Henry, R., & Irwin, M. R. (2021). Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial. PloS one, 16(1), e0244717. https://doi.org/10.1371/journal.pone.0244717

 

Abstract

The objective of this randomized controlled trial was to test whether a commercially available, mindfulness meditation mobile app, (i.e., Calm app), was effective in reducing fatigue (primary outcome), pre-sleep arousal, and daytime sleepiness (secondary outcomes) in adults with sleep disturbance (Insomnia Severity Index Score >10) as compared to a wait-list control group. Associations between the use of the Calm app (i.e., adherence to the intervention) and changes in sleep quality was also explored in the intervention group only. Adults with sleep disturbance were recruited (N = 640). Eligible and consenting participants (N = 263) were randomly assigned to the intervention (n = 124) or a wait-list control (n = 139) group. Intervention participants were asked to meditate using the Calm app ≥10 minutes/day for eight weeks. Fatigue, daytime sleepiness, and pre-sleep arousal were assessed at baseline, mid- (4-weeks) and post-intervention (8-weeks) in both groups, whereas sleep quality was evaluated only in the intervention group. Findings from intent-to-treat analyses suggest the use of the Calm app for eight weeks significantly decreased daytime fatigue (p = .018) as well as daytime sleepiness (p = .003) and cognitive (p = .005) and somatic (p < .001) pre-sleep arousal as compared to the wait-list control group. Within the intervention group, use of the Calm app was associated with improvements in sleep quality (p < .001). This randomized controlled trial demonstrates that the Calm app can be used to treat fatigue, daytime sleepiness, and pre-sleep arousal in adults with sleep disturbance. Given that the Calm app is affordable and widely accessible, these data have implications for community level dissemination of a mobile app to improve sleep-related symptoms associated with sleep disturbance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790277/

 

Maintain Vacation Benefits with Meditation

Maintain Vacation Benefits with Meditation

 

By John M. de Castro, Ph.D.

If you’re going to go on a vacation see if you can integrate meditation to really double up on that impact.” – Elisha Goldstein

 

A leisure vacation can rejuvenate the individual in body and mind. It decreases mental and physical fatigue and increases happiness. But unfortunately, its effects rapidly dissipate. It doesn’t take long for the positive benefits to wear off. Meditation retreats also rejuvenate the individual in body and mind, decreasing fatigue and increasing happiness. The effects of meditation appear have been generally found to be relatively longer lasting. Attending a meditation retreat or including meditation on vacation may help to sustain the effectiveness of the vacation for a longer period of time.

 

In today’s Research News article “Is a meditation retreat the better vacation? effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869997/ ) Blasche and colleagues recruited adult participants in meditation retreats and also individuals who planned a vacation over the same period of time. They separated the vacation participants who did and did not include meditation in their vacation. They were measured before and after the retreat/vacation and

weeks later for acting with awareness, fatigue, emotional well-being, relaxation, control, and mastery.

 

They found that after the retreat/vacation all groups had significant reductions in fatigue and emotional well-being while on the retreat and vacation with meditation groups had significant increases in acting with awareness. Ten weeks later, however, only the retreat and vacation with meditation groups had maintained significant increases in acting with awareness and emotional well-being and decreases in fatigue.

 

These are interesting findings. But, it needs to be recognized that this was not a randomized study and the participants who chose to go on retreat or those who meditate during a vacation may be significantly different than those who do not meditate during the vacation. People who meditate may be the kinds of people who get the most out of their vacations.

 

Regardless, the results suggest that all types of vacations improve the physical and mental health of the participants, when meditation is not included the benefits fade over the next few weeks. But including meditation either in retreat of during a vacation significantly improves the longevity of the benefits. This further suggests that including some quiet reflective time in a vacation is important in maximizing the impact of the vacation on the well-being of the participants.

 

So, maintain vacation benefits with meditation.

 

So the “vacation effect” brings short term good news for everyone, and the “meditation effect” brings longer-lasting good news, especially when you keep at it!” – Crystal Goh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Blasche, G., deBloom, J., Chang, A., & Pichlhoefer, O. (2021). Is a meditation retreat the better vacation? effect of retreats and vacations on fatigue, emotional well-being, and acting with awareness. PloS one, 16(2), e0246038. https://doi.org/10.1371/journal.pone.0246038

 

Abstract

It is well established that leisure vacations markedly improve well-being, but that these effects are only of short duration. The present study aimed to investigate whether vacation effects would be more lasting if individuals practiced meditation during the leisure episode. Meditation is known to improve well-being durably, among others, by enhancing the mental faculty of mindfulness. In this aim, leisure vacations during which individuals practiced meditation to some extent were compared with holidays not including any formal meditation practice as well as with meditation retreats (characterized by intense meditation practice) utilizing a naturalistic observational design. Fatigue, well-being, and mindfulness were assessed ten days before, ten days after, and ten weeks after the stays in a sample of 120 individuals accustomed to meditation practices. To account for differences in the experience of these stays, recovery experiences were additionally assessed. Ten days after the stay, there were no differences except for an increase in mindfulness for those practicing meditation. Ten weeks after the stay, meditation retreats and vacations including meditation were associated with greater increases in mindfulness, lower levels of fatigue, and higher levels of well-being than an “ordinary” vacation during which meditation was not practiced. The finding suggests that the inclusion of meditation practice during vacation could help alleviate vacations’ greatest pitfall, namely the rapid decline of its positive effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869997/

 

Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a good resource for dealing with the physical and psychological symptoms of metastatic disease. Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. The Mindfulness-Based Stress Reduction (MBSR) program is a mindfulness training program that includes meditation practice, body scan, yoga, and discussion along with daily home practice. MBSR has been shown to be beneficial for cancer patients in general and also specifically for the symptoms of breast cancer survivors. So, it makes sense to further explore the effectiveness of MBSR training for the treatment of breast cancer survivors.

 

In today’s Research News article “Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/ ) Reich and colleagues recruited breast cancer survivors and randomly assigned them to either usual care or to receive a 6-week, once a week for 2-hours, Mindfulness-Based Stress Reduction (MBSR) modified for breast cancer survivors. They were measured before and after training and 6 weeks later for worry, fear of cancer recurrence, anxiety, depression, perceived stress, mindfulness, symptom severity, sleep quality, fatigue, pain, cognition, and health-related quality of life.

 

They found with factor analysis that the measures fit into 4 clusters; pain, cognition, fatigue, and psychological. They found that in comparison to baseline the usual care, Mindfulness-Based Stress Reduction (MBSR) produced significant improvement in the psychological and fatigue clusters, but not the cognitive or pain clusters. These effects were still present 6 weeks later.

 

These findings suggest that Mindfulness-Based Stress Reduction (MBSR) is an effective treatment to relieve the psychological and fatigue symptoms of breast cancer survivors. This corresponds with prior findings that mindfulness improves the symptoms of breast cancer survivors and reduces anxiety, depression, and perceived stress, and improves emotional well-being and also reduces fatigue and improves sleep quality.

 

The observed improvements produced by Mindfulness-Based Stress Reduction (MBSR) markedly improves the quality of life and reduces the suffering of these cancer patients. These are clinically significant. It has been shown that an improved psychological outlook is associated with better physical recovery. Hence, these findings suggest that MBSR or other mindfulness training programs, should be incorporated into the routine care of breast cancer survivors.

 

So, improve the psychological well-being of breast cancer survivors with mindfulness.

 

Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally. . .  Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are.“ – Breast Cancer Now

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Reich, R. R., Lengacher, C. A., Alinat, C. B., Kip, K. E., Paterson, C., Ramesar, S., Han, H. S., Ismail-Khan, R., Johnson-Mallard, V., Moscoso, M., Budhrani-Shani, P., Shivers, S., Cox, C. E., Goodman, M., & Park, J. (2017). Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters. Journal of pain and symptom management, 53(1), 85–95. https://doi.org/10.1016/j.jpainsymman.2016.08.005

 

Abstract

Context.

Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters.

Objectives.

The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program.

Methods.

Three hundred twenty-two Stage 0–III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress, and fear of recurrence), physical (fatigue, pain, sleep, and drowsiness), and cognitive symptoms and quality of life were assessed at baseline, six, and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models offactor analysis and structural equation modeling.

Results.

Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks, the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (P = 0.007) and fatigue (fatigue, sleep, and drowsiness) (P < 0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed.

Conclusion.

Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/

 

Movement-Based Therapies are Affective for Rehabilitation from Disease

Movement-Based Therapies are Affective for Rehabilitation from Disease

 

By John M. de Castro, Ph.D.

 

Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Havard Health

 

Mindful movement practices such as yoga and Tai Chi and Qigong have been used for centuries to improve the physical and mental health and well-being of practitioners. But only recently has the effects of these practices come under scientific scrutiny. This research has been accumulating. So, it makes sense to pause and examine what has been learned about the effectiveness of these practice for rehabilitation from disease.

 

In today’s Research News article “Movement-Based Therapies in Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/ ) Phuphanich and colleagues review and summarize the published research studies of the effects of mindful movement practices on rehabilitation from disease.

 

They report that published research has found that yoga practice reduces fatigue, sleep disturbances, depression, and anxiety and improves the immune system in cancer patients. Yoga has been found to be an effective treatment for mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). Yoga has been found to reduce pain levels, fear avoidance, stress, and sleep disturbance and increases self-efficacy and quality of life in chronic pain patients. Yoga has been found to improve the symptoms of traumatic brain injury, stroke, spinal cord injury, Parkinson disease, dementia, multiple sclerosis, epilepsy, and neuropathies. In addition, yoga has been found to improve systolic and diastolic blood pressures, heart rate, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, hemoglobin A1c, and insulin resistance in cardiopulmonary diseases.

 

They report that the published research has found that Tai Chi and Qigong practices reduce falls in the elderly. Tai Chi and Qigong has been found to reduce pain levels and increase quality of life in chronic pain patients. In addition, there is evidence that Tai Chi and Qigong practices improves depression, anxiety, posttraumatic stress disorder, sleep disturbance, schizophrenia, rheumatoid arthritis, spinal cord injury, traumatic brain injury, and immune disorders.

 

These are remarkable findings. The range of disorders that are positively affected by yoga, Tai Chi, and Qigong practices is breathtaking. These practices are also safe and can be widely implemented at relatively low cost and can be performed alone or in groups and at home or in a therapeutic setting. This suggests that these practices should be routinely implemented for rehabilitation from disease.

 

So,  movement-based therapies are affective for rehabilitation from disease.

 

Being mindful through any physical activity can not only improve performance in the activity such as yoga, tennis, swimming, etc, but it can also increase flexibility, confidence in movement and generate a sense of body and mind connection that has the potential for improving your overall sense of well-being.“- Anupama Kommu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Phuphanich, M. E., Droessler, J., Altman, L., & Eapen, B. C. (2020). Movement-Based Therapies in Rehabilitation. Physical medicine and rehabilitation clinics of North America, 31(4), 577–591. https://doi.org/10.1016/j.pmr.2020.07.002

 

Abstract

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one’s own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

Key Points – Movement-based therapies

  • Decrease fear avoidance and empower individuals to take a proactive role in their own health and wellness.
  • Can benefit patients of any ability; practices are customizable to the individual’s needs and health.
  • Are safe, cost-effective, and potent adjunct treatments used to supplement (not replace) standard care.
  • Deliver patient-centered, integrative care that accounts for the physical, psychological, social, and spiritual aspects of health and illness.
  • Have diverse, evidence-based benefits, including reduction in pain, stress, and debility, and improvements in range of motion, strength, balance, coordination, cardiovascular health, physical fitness, mood, and cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/

 

Mindful Eating is Related to Less Binge Eating and Fewer Mood Disorders

Mindful Eating is Related to Less Binge Eating and Fewer Mood Disorders

 

By John M. de Castro, Ph.D.

 

“Paying attention to what you are eating is the most effective way to attain a positive relationship with food and therefore find your ideal healthy weight.” – UT Counseling

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder; either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. So, college age students are particularly vulnerable. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Binge eating disorder involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating.

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders.

 

Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake by affecting the individual’s response to non-homeostatic cues for eating. Indeed, high levels of mindfulness are associated with lower levels of obesity and mindful eating has been shown to improve eating behaviors. Hence, mindful eating may counter binge eating. So, it is important to investigate the relationship of mindful eating to mood and binge eating.

 

In today’s Research News article “Mindfulness in Eating Is Inversely Related to Binge Eating and Mood Disturbances in University Students in Health-Related Disciplines.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071141/ ) Giannopoulou and colleagues recruited college students and had them complete online measures of mood, mindful eating, and binge eating. They then compared students with binge eating to non-binge eaters and the data were subjected to regression analysis.

 

They found that 41% of the students met the criterion for binge eating. In comparison to non-binge eating students, the binge eaters had significantly higher levels of tension, depression, anger, fatigue, and confusion and significantly lower levels of vigor and mindful eating. Similarly, female students had significantly higher levels of tension, depression, anger, fatigue, and confusion and significantly lower levels of vigor and mindful eating. In addition, the higher the level of mindful eating the higher the mood scores and the lower the binge eating score.

 

It should be noted that these results are correlational. So, conclusions about causation cannot be made directly. But prior research has demonstrated that training in mindfulness produces reductions in binge eating and improvements in mood. Including decreases in, depression, anger, and fatigue. So, the present results probably result from causal connections.

 

The results then suggest that binge eating is associated with negative mood states. College students are particularly vulnerable to negative moods and binge eating. The results also suggest that mindful eating may be an antidote to negative moods and binge eating. This suggests that training in mindful eating might work to lessen or prevent these problems so rampant in college students.

 

So, mindful eating is related to less binge eating and fewer mood disorders.

 

Practicing mindfulness can help you recognize when you’re no longer hungry, which can improve your eating behaviors and reduce the incidence of binge eating.” – Rachel Link

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Giannopoulou, I., Kotopoulea-Nikolaidi, M., Daskou, S., Martyn, K., & Patel, A. (2020). Mindfulness in Eating Is Inversely Related to Binge Eating and Mood Disturbances in University Students in Health-Related Disciplines. Nutrients, 12(2), 396. https://doi.org/10.3390/nu12020396

 

Abstract

The purpose of the study was to investigate the relationship between mindful eating, disordered eating and mood in university students in health-related disciplines. A total of 221 university students participated in the study; 102 students studied sport and exercise science (SS), 54 students pharmacy sciences (PS), and 65 students health sciences (HS). Participants completed the Binge Eating Scale (BES), the Mindful Eating Questionnaire (MEQ), and the Profile of Mood State questionnaire (POMS). 41% of the students were classified as binge eaters and 57% were above the POMS threshold of depression. Binge eaters were found to have significantly lower MEQ score and significantly higher total mood disturbance scores (TMD) compared to non-binge eaters (p < 0.01). Students with a high depression score exhibited no differences in the MEQ score but a significantly higher BES score compared to non-depressed students (p < 0.01). Gender differences were found in the MEQ with females exhibiting significantly higher scores in the MEQ score and in all MEQ subscales compared to males, with the exception of the emotional subscale that females were noted to have a lower score compared to males (p < 0.01). The MEQ score was inversely related to the BES score (r = −0.30, p < 0.01) and TMD (r = −0.21, p < 0.05). The MEQ score was a significant negative predictor of the variance of the binge eating behavior of the students (B = −3.17, p < 0.001). In conclusion, mindfulness in eating is inversely related to the binge eating behavior and mood state of university students studying health-related subjects and is a significant negative predictor of disordered eating behavior in this high risk population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071141/

 

Improve Stress Responding, Health, and Well-Being with Qigong

Improve Stress Responding, Health, and Well-Being with Qigong

 

By John M. de Castro, Ph.D.

 

Qigong is an extraordinary tool for reducing the harmful effects of stress. The three pillars of qigong practice are body, breath, and mind. If your body is relaxed your breathing will slow down. When your breath is slow, you feel more centered, more calm, and more in touch with yourself” – Kenneth Cohen

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

Tai Chi and Qigong are both mindfulness practices and gentle exercises. They have been shown to be beneficial for the health and well-being of individuals of a variety of ages, but particularly the elderly. They also improve the symptoms of a variety of diseases. One way that these practices may improve health and well-being is by reducing stress. The studies of the benefits for health of Tai Chi and Qigong are accumulating and so it makes sense to take a moment to summarize what has been learned about the benefits of Qigong practice.

 

In today’s Research News article “Individual Stress Prevention through Qigong.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579037/ )  van Dam reviews and summarizes the published research studies of the effects of Qigong practice on stress. She reports that the published studies found that Qigong practice improves the cardiovascular system including a significant reduction in blood pressure and an increase in heartrate variability, an indicator of parasympathetic relaxation. It improves the respiratory system including increased lung capacity, oxygen intake and breathing patterns. It improves immune function and reduces inflammatory responses. It improves both psychological and physiological responses to stress. It improves sleep quality and reduces fatigue. It reduces depression and both acute and chronic anxiety.

 

These findings are remarkable and suggest that this gentle safe practice markedly improves the physical and mental well-being and health of the practitioners. Many of these benefits may result from the ability of Qigong practice to improve stress responding. Stress impairs health and well-being and Qigong practice appears to counteract these effects.

 

So, improve stress responding, health, and well-being with Qigong.

 

Qi Gong helps you develop a crystal clear mind as you connect with the present moment, letting go of the stress of daily life and relaxing deeply.”- Nick Jankel

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

van Dam K. (2020). Individual Stress Prevention through Qigong. International journal of environmental research and public health, 17(19), 7342. https://doi.org/10.3390/ijerph17197342

 

Abstract

Owing to work intensification and an accelerated pace of life in general, individuals in many Western countries are often overactivated and find it difficult to switch off. However, recovery from physiological and mental activation is critical to prevent stress symptoms and maintain one’s physiological and mental well-being. Extensive research evidence indicates that Qigong, a traditional Chinese movement practice for promoting health, provides an effective means to recover from work and off-work demands. The main objective of this paper is to offer a comprehensive, narrative review of the effects of Qigong and its core components. Attention is first paid to the outcomes of work and off-work demands and stress, and the role of recovery for individuals’ well-being. Then, Qigong and its components are explained, followed by the results of scientific research. Finally, limitations and implications for research and practiced are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579037/

 

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbancefear, and anxiety and depression. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients.

 

In today’s Research News article “Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/ ) Matis and colleagues review, summarize, and perform a meta-analysis on the published research studies on the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients. They identified 24 published research studies including at least 4 weeks of mindfulness training delivered over the internet.

 

They report that the published research studies found that mindfulness training delivered over the internet to cancer patients produced significant decreases in stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. In the few studies where long-term follow-up measures were obtained the effects were maintained.

 

These are very promising results that suggest that mindfulness training over the internet is a safe and effective treatment for the psychological issues common in cancer survivors. Mindfulness training, in general, has been shown in a large number of previous studies o be effective in reducing stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. So, the present study simply extends these findings to patients with cancer who receive mindfulness training over the internet.

 

These results are important as good mental health, particularly the ability to cope with stress, are predictors of good health outcomes. In addition, the fact that the interventions were provided over the internet allows for cost-effective and convenient delivery to patients. This makes participation and compliance more likely and effective. Hence, internet-based mindfulness training may help relieve the psychological suffering of patients diagnosed with cancer and should be included in their treatment plan.

 

So, improve the psychological health of cancer patients with mindfulness taught over the internet.

 

Both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Matthew Stenger

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Matis, J., Svetlak, M., Slezackova, A., Svoboda, M., & Šumec, R. (2020). Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. Journal of medical Internet research, 22(11), e20709. https://doi.org/10.2196/20709

 

Abstract

Background

eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.

Objective

This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.

Methods

In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.

Results

A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.

Conclusions

Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/

 

Reduce Fatigue and Improve Quality of Life of Breast Cancer Survivors with Yoga

Reduce Fatigue and Improve Quality of Life of Breast Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“For women with breast cancer, research shows those who practice yoga may also have less stress and fatigue, and better quality of life.” – Stacie Simon

 

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. The research on yoga practice as a treatment for patients recovering from breast cancer has been accumulating. It is thus reasonable to take a step back and summarize what has been learned.

 

In today’s Research News article “The Effect of Yoga Interventions on Cancer-Related Fatigue and Quality of Life for Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580184/ ) O’Neill and colleagues review, summarize, and perform a meta-analysis of published randomized controlled trials of the effects of yoga practice on the fatigue and quality of life of breast cancer survivors. They identified 24 published randomized controlled trials.

 

They report that the published trials revealed that yoga practice produced significant reductions in cancer related fatigue and increases in the women’s quality of life. This was true overall and for the 18 trials with a passive control group such as a wait-list control, but not for the 6 trials with an active control group, such as physical exercise or supportive therapy. Hence, yoga practice appears to be beneficial for breast cancer survivors reducing fatigue and improving quality of life. But the benefits are comparable to those produced by other exercises or therapies.

 

So, reduce fatigue and improve quality of life of breast cancer survivors with yoga.

 

A targeted yoga intervention led to significant improvements in fatigue and vigor among breast cancer survivors with persistent fatigue symptoms.” – Julienne Bower

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

O’Neill, M., Samaroo, D., Lopez, C., Tomlinson, G., Santa Mina, D., Sabiston, C., Culos-Reed, N., & Alibhai, S. (2020). The Effect of Yoga Interventions on Cancer-Related Fatigue and Quality of Life for Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Integrative cancer therapies, 19, 1534735420959882. https://doi.org/10.1177/1534735420959882

 

Abstract

Background:

Women with breast cancer (BC) are living longer with debilitating side effects such as cancer-related fatigue (CRF) that affect overall well-being. Yoga promotes health, well-being and may be beneficial in reducing CRF. Although there have been previous systematic reviews and meta-analyses, the effects of yoga on CRF and quality of life (QOL) remain unclear, particularly in comparison with other types of physical activity (PA). Our objective is to carry out a systematic review and meta-analysis of the effects of yoga on CRF and QOL in women with BC.

Methods:

Electronic databases were searched (MEDLINE, Embase Classic+Embase and EMB Reviews, Cochrane Central CT) from inception to May 2018. Randomized controlled trials were included if they were full text, in English, included a yoga intervention, a comparator (including non-PA usual care or alternate PA intervention), and reported on CRF or QOL. Effects of yoga were pooled using standardized mean difference (SMD) via a random effects model.

Results:

Of the 2468 records retrieved, 24 trials were included; 18 studies compared yoga to a non-PA comparator and 6 to a PA comparator. Yoga demonstrated statistically significant improvements in CRF over non-PA (SMD −0.30 [−0.51; −0.08]) but not PA (SMD −0.17 [−0.50; 0.17]) comparators. Additionally, yoga demonstrated statistically significant improvements in QOL over non-PA (SMD −0.27 [−0.46; −0.07]) but not PA (SMD 0.04 [−0.22; +0.31]) comparators.

Discussion:

This meta-analysis found that yoga provides small to medium improvements in CRF and QOL compared to non-PA, but not in comparison to other PA interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580184/

 

Manage Symptoms in Cancer Survivors with Yoga

Manage Symptoms in Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“when it’s used alongside conventional medical treatment, yoga may help relieve some of the symptoms linked to cancer.” – American Cancer Society

 

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. This is particularly true with metastatic cancer. 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 . 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. So, it’s reasonable to review what has been learned about the benefits of yoga practice to improve the residual symptoms of patients who have survived cancer.

 

In today’s Research News article “Yoga for symptom management in oncology: A review of the evidence base and future directions for research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/ ) Danhauer and colleagues review and summarize the published randomized controlled studies of the effectiveness of yoga practice for the treatment of the symptoms of cancer survivors. They identified 29 published randomized controlled trials, 13 conducted during treatment, 12 after treatment, and 4 both before and after.

 

They report that the published research found that yoga during treatment for cancer significantly improved the patient’s quality of life, including physical, emotional social, and cognitive quality of life. They also report that yoga significantly reduced fatigue, distress, perceived stress, and biomarkers of stress and inflammation. Yoga after treatment completion was found to significantly reduce fatigue and sleep disturbance and improve quality of life. There were no serious adverse events resulting from yoga practice reported.

 

The published research then suggests that yoga practice is a safe and effective treatment both during and after cancer treatment for the relief of the patients’ residual physical and psychological symptoms. Yoga practice is a complex of practices that includes postures, breath control, and meditation. It has not been clearly established which of these components or which combination of components are required for the benefits. So, conclusions cannot be made regarding mechanisms of action by which yoga produces its benefits. But it can be concluded that yoga practice is very beneficial for cancer sufferers.

 

So, manage symptoms in cancer survivors with yoga.

 

yoga can combat fatigue and improve strength and range of motion for patients undergoing cancer treatment,” – Dr. Maggie DiNome

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are a also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Danhauer, S. C., Addington, E. L., Cohen, L., Sohl, S. J., Van Puymbroeck, M., Albinati, N. K., & Culos-Reed, S. N. (2019). Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer, 125(12), 1979–1989. https://doi.org/10.1002/cncr.31979

 

Abstract

As yoga is increasingly recognized as a complementary approach to cancer symptom management, patients/survivors and providers need to understand its potential benefits and limitations both during and after treatment. We reviewed randomized controlled trials (RCTs) of yoga conducted at these points in the cancer continuum (N=29; n=13 during treatment, n=12 post-treatment, n=4 with mixed samples). Findings both during and after treatment demonstrated efficacy of yoga to improve overall quality of life (QOL), with improvement in subdomains of QOL varying across studies. Fatigue was the most commonly measured outcome, and most RCTs conducted during or after cancer treatment reported improvements in fatigue. Results additionally suggest that yoga can improve stress/distress during treatment and post-treatment disturbances in sleep and cognition. A number of RCTs showed evidence that yoga may improve biomarkers of stress, inflammation, and immune function. Outcomes with limited or mixed findings (e.g., anxiety, depression, pain, cancer-specific symptoms such as lymphedema, positive psychological outcomes such as benefit-finding and life satisfaction) warrant further study. Important future directions for yoga research in oncology include: enrolling participants with cancer types other than breast, standardizing self-report assessments, increasing use of active control groups and objective measures, and addressing the heterogeneity of yoga interventions, which vary in type, key components (movement, meditation, breathing), dose, and delivery mode.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/