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Randomized Controlled Trial
. 2021 Dec;29(12):7725-7735.
doi: 10.1007/s00520-021-06345-z. Epub 2021 Jun 22.

Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy

Teresa Zetzl  1 , Andre Pittig  2   3 , Agnes Renner  4 , Birgitt van Oorschot  4 , Elisabeth Jentschke  4   5
Affiliations
Randomized Controlled Trial

Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy

Teresa Zetzl et al. Support Care Cancer. 2021 Dec.

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.

Keywords: Complementary alternative medicine; Fatigue; Long-term effects; Mind–body intervention; Reminder e-mails; Yoga.

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Conflict of interest statement

Zetzl and Renner report grants from Deutsche Krebshilfe/German Cancer Aid, during conduct of the study. The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT diagram showing screening, allocation, and participant flow by group
Fig. 2
Fig. 2
Mean changes in A EORTC QLQ-FA12 general fatigue and B EORTC QLQ-FA12 emotional fatigue between T1 and T2 in e-mail group and no-e-mail group. Results show means and 95% CI
Fig. 3
Fig. 3
Mean changes in A EORTC QLQ-FA12 general fatigue, B PHQ-9 Depression Score, and C EORTC QLQ-C15-PAL quality of life between T0, T1, and T2 in all participants. Results show means and 95% CI
See this image and copyright information in PMC

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