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Feasibility of Yoga Intervention among Cancer Survivors : Pilot results indicate contemplative yoga improves emotional and spiritual well-being
| Content Provider | Semantic Scholar |
|---|---|
| Author | Brown, Cheryl Fenner Jacobson, Dawn Marie Laurent, Cecile A. Kubo, Ai |
| Copyright Year | 2016 |
| Abstract | To assess the feasibility of offering standardized yoga protocols as a complementary approach to improve post-treatment side-effects in cancer patients, and obtain pilot results of association between their practice and cancer-related quality of life. Seventeen survivors (88% women, age=55 years, 34% breast cancer, 66% others, months post-treatment=39) participated in eight weekly, 90-minute sessions using the Healing Yoga for Cancer Survivorship (HYCS) protocol comprised of active (reclining, seated, kneeling, standing, restorative postures) and contemplative practices (intention setting, chanting, mudra, pranayama, body scan, guided relaxation). Participants reported daily on which HYCS protocols were practiced and quality of life domains (physical, functional, emotional, spiritual) using online tool based on validated FACT-G and FACT-Sp questionnaires. Association between yoga practice and QoL analyzed using the generalized estimated equation model (GEE). Participants used intention setting (29 days), breathing (25 days), reclining asana (24 days), and mudra (21 days) most frequently (attendance=67.6%, daily reporting rate=72.4%) Participation in active HYCS showed a 60% increase in emotional wellbeing [RR=1.60, 95% CI (1.06-2.40), p=0.02], specifically reclining asana [RR=6.24, 95% CI (1.44-27.10), p=0.01], standing asana [RR=6.06, 95% CI (1.08-33.85), p=0.04], and restorative asana [RR=5.07, 95% CI (1.15-22.42), p=0.03]. Participation in contemplative HYCS showed an 87% increase in spiritual well-being [RR=1.87, 95% CI (1.12-3.11), p=0.02], specifically body scan [RR=4.78, 95% CI (1.31-17.43), p=0.02], and final relaxation [RR=3.62, 95% CI (1.10-11.87), p=0.03]. This study demonstrates the feasibility of offering a comprehensive therapeutic yoga protocol for cancer survivors including contemplative practices that may help improve participant’s emotional and spiritual quality of life. Introduction The word yoga is from the Sanskrit root yuj, which means to join or yoke together in union, philosophically referring to the union of the individual self with the universal self that can occur through the practice of yoga. There are a variety of forms of yoga, each with their own practices and ideals. Hatha yoga is the root of many other physical forms of the practice such as Iyengar, Restorative, and Anusara. The word hatha is a combination of ha, or sun, and tha, or moon; when joined these words are translated as ‘forceful’. It is believed that through the physical yoga practice, the practitioner balances these two complementary energies that imbue all life, and through this balance, the body is made strong and steady. It is commonly believed that the Yoga Sutra, one of earliest texts describing the practices of Hatha yoga, was authored by Patanjali and compiled around 400 C.E. In this treatise of aphorisms, Patanjali outlines the method and benefits of practicing the eight-limbed path of Hatha yoga. These eight limbs are yama, moral observances of how to best interact with others; niyama, self-restraints to reduce inner suffering; asana, the physical postures; pranayama, control of the breath; pratyahara, drawing awareness inward; dharana, or one-pointed concentration; dhyana, or absorption with the object of meditation; and samadhi, or awareness of oneness. As a whole, this system of physical and contemplative practices enhances body awareness, encourages the distribution of vital energy, and promotes wellness. According to the Taittiriya Upanishad, there are five sheaths or layers that make up the Atman, or Self. From the gross to the subtle, the five sheaths are anamaya kosha, the food sheath or physical body; pranamaya kosha, the energy sheath or pranic body; manomaya kosha, the mental/emotional sheath or our everyday thoughts and reactions; vjnanamaya kosha, the wisdom sheath or witness consciousness; and anandamaya kosha, the bliss sheath or soul. The different practices of the eight–limbed path of Hatha yoga enable the practitioner to positively affect the koshas. For example, the practice of asana strengthens anamaya kosha; the practice of pranayama strengthens pranamaya kosha; and practicing pratyahara, dharana, and dhyana create calm within manomaya kosha, providing greater access to vijnanamaya and annandamaya koshas. Therefore, depending on which limbs of yoga are practiced, changes may be made within different domains of well-being. According to a survey published by Yoga Alliance in 2016, more than 36 million Americans have practiced yoga in the past six months, and over 70% of those who practice regularly are women. It is also reported that 10% of practitioners began practicing because of a medical condition, but only 6% say they received recommendations from a traditional doctor/nurse/physical therapist. Practitioners’ motivation to continue practicing yoga reportedly varies from flexibility (59%), to stress reduction (53%), to general fitness (47%), to improving overall health (48%), to mental health (35%), to spiritual development (23%), among others. The vast majority, 67% of practitioners report that they do yoga in their homes. Additionally, it was reported in study of over 34,500 American adults surveyed in 2012 that 13% were lifetime yoga practitioners. Of those, 90% used breathing exercises and 55% used meditation. In 2016, an estimated 1.65 million new cancer cases are expected to be diagnosed, with cancers of the digestive system, breast, prostate, and lung comprising the most common types. As of January 1, 2014, there were an estimated 14.5 million cancer survivors in the United States, with a 5-year relative survival rate of 69% for all cancers diagnosed during 2005-2011. This was an improvement from the 1975 survival rate of less than 50%. Despite greater survival, cancer and its allopathic treatments are often associated with a reduction in quality of life (QoL) across physical, functional, emotional, and spiritual domains that may include pain, insomnia, fatigue, digestive disturbance, inability to work, anxiety, and hopelessness. These side-effects range from acute, which occur during treatment and last for a short period of time, to chronic, which occur during treatment and may last months or years, to late, which occur months or years after treatment has ended. Meta-analysis shows that exercise interventions may have variable beneficial effects on function within physical, role, and social domains, including cancer-related fatigue, cognitive impairment, sleep problems, depression, pain, anxiety, and physical dysfunction among cancer survivors. When comparing yoga to other forms of exercise (e.g., walking, running, dancing, bicycling), yoga proves to be as effective as, or better than other exercise in improving many health-related outcomes including fatigue, mood, pain, sleep disturbance, and stress. Research also suggests that yoga is a well-tolerated form of exercise for cancer survivors, and beneficial for managing fatigue, insomnia, stress, mood disturbances, and distress. Approximately 21% of cancer survivors in the United States engaged in complementary and alternative (CAM) practices to help manage the effects of their illness. The third most common CAM practice used among cancer survivors was yoga. There are many different types of yoga (e.g., Hatha, Iyengar, Ashtanga, Vinyasa, Yin), and all types of yoga may not be appropriate for all cancer survivors. The survivor’s previous exposure to yoga, their overall health, previous injuries, and other factors may preclude them from practicing a more vigorous style of yoga (e.g., Ashtanga, Bikram, Power Vinyasa), as these styles may be too challenging to be considered therapeutic for post-treatment care. Research suggests that Hatha yoga and restorative yoga are quickly gaining acceptance in Western medicine for therapeutic use. Research also suggests that meditative movement therapies, such as the more contemplative forms of yoga and mindfulness, may be helpful for improving healthrelated QoL in certain conditions, including cancer. Therefore, it is important that yoga protocols be tested for their safety and effectiveness in managing survivors’ QoL. However, what the previous research lacks is data collected on how individual yoga practices impact survivor’s QoL. Merely using the word ‘yoga’ to describe an intervention fails to provide enough detail as the practices included in ‘yoga’ can vary widely between active and restorative asanas or various calming and energizing breathing techniques, even within the same tradition. When a yoga intervention includes many different practices, how can we determine whether an increase in well-being was due to the active asana practice or a guided final relaxation? This point was key when developing the Healing Yoga for Cancer Survivorship (HYCS) protocol, and this study addresses the following questions: (1) Can a standardized protocol that includes a wide array of physical and contemplative yoga techniques significantly affect QoL and reduce reported residual side-effects in the post-treatment results of a variety of types of cancer patients? (2) Does more consistent practice of a standardized protocol correlate with stronger improvements in measured outcomes and greater reduction of residual treatment side-effects? (3) Which yoga practices (physical or contemplative) have the greatest effect on QoL across physical, functional, emotional, and spiritual domains? Objectives There were two main objectives of the study: (1) To assess the feasibility of offering the standardized HYCS protocol as a CAM practice to improve post-treatment side effects and overall QoL of cancer survivors. The HYCS protocol contains physical practices (reclining, seated, kneeling, standing, and restorative asana) and contemplative practices (intention setting, chanting, mudra, pranayama, body scan, and final relaxation). (2) To obtain pilot data on the relationship between the yoga practice and four QoL domains |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://www.yogacheryl.com/uploads/1/0/9/1/10914508/brown-feasibility_of_yoga_intervention_among_cancer_survivors.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
