Research Trial: The Yoga Mat, Where East Meets West

The Yoga Mat, Where East Meets West: Evaluating a Structured Yoga Practice on Common Side Effects of Chemotherapy/Biotherapy in Cancer Patients

  • Patricia Johnson, BS, RN, OCN, CBCN – Oncology Care Coordinator, Breast Care Navigator; University of Vermont Health Network CVPH
  • Carlyn Haag, MS, RN-BC, CCRN-K
  • Mary Nolan, RN, OCN UVMHN- Champlain Valley Physicians Hospital, Plattsburgh, NY

As published in the Journal of Oncology Navigation & Survivorship. (September 2019 Vol 10, N0 9). Read full results.


Background: Eight of the most commonly experienced physiological and psychosocial side effects of cancer chemotherapy/biotherapy are pain, tiredness, drowsiness, nausea, lack of appetite, shortness of breath, depression, and anxiety. Yoga is a complementary health approach recognized by the National Institutes of Health.

Objectives: To evaluate the effects of a structured yoga program on specific physiological and psycho­social side effects in patients undergoing active treatment with chemotherapy/biotherapy.

Methods: This quantitative, non-experimental pilot study with anecdotal commentary utilized descriptive statistics. Participants (N = 8) self-rated these side effects using a validated instrument at 10 points during an 8-week structured yoga intervention. Effect size and means were calculated at select data points: baseline, week 8, and 1 month after study completion.

Results: Reported ratings demonstrated improvement in many symptoms at week 8, and an increase in some of these symptoms’ recurrence 1 month after study completion. Interestingly, participants’ self-report of overall well-being demonstrated a positive improvement. Effect size was calculated: Cohen’s d of 0.56 measured from baseline to week 8 yielded a medium effect size, and Cohen’s d of 0.36 measured from week 8 to post study completion yielded a small effect size.

Conclusions: Participants in a structured yoga program reported a decrease in many of the negative side effects of chemotherapy/biotherapy and improvement in feeling of overall well-being. Limitations of this study included variability of cancer diagnoses, sample size, and consistency of class attendance. Yoga can be one of many supports offered by the oncology nurse navigator.

As published in the Journal of Oncology Navigation & Survivorship. (September 2019 Vol 10, N0 9) Read full results.

Sample Results: Please review the full results.

Descriptive analysis was performed (N = 8). Aggregate means of individual ratings were calculated at baseline, week 4, week 8, and 1 month after yoga intervention for each symptom assessed. A reduction in any symptoms during the intervention period and an increase 1 month after completion were anticipated. There was a decrease in nausea from baseline (M = 1.13) to postintervention (M = 0.5). Decreases in pain, shortness of breath, and depression were not demonstrated at the points measured. Anxiety decreased from baseline (M = 2.89) to week 4 (M = 1.44), increased at week 8 (M = 1.67), then decreased slightly postintervention (M = 1.63) (Figure 2). As seen in Figure 3, there was a decrease in ratings of tiredness, lack of appetite, drowsiness, and well-being from baseline at week 4 and week 8, and an increase postintervention. Lower ratings demonstrated improvement in symptoms based on ESAS-r (0 = best, 10 = worst). These results support the study’s hypothesis.

Due to treatment schedules, hospitalizations, and previously planned “life-affirming” events, only 2 participants were able to attend all 8 yoga sessions. Because of the extremely small sample and inability to achieve statistical significance, effect size was calculated to further understand the size of the impact of the intervention on the participants. Effect size was calculated at baseline, week 8, and 1 month after completion for each of the side effects evaluated on the ESAS-r (Table 1). Effect size is determined by calculating the mean of comparison groups and dividing by the standard deviation. Effect size values are correlated to a standard measurement, Cohen’s d, which is then used to compare the calculated effect size values.

Please review the full results.