Feasibility of a remotely-delivered yoga intervention on cognitive function in breast cancer survivors: a mixed-methods study

Alyssa R. Neville, Lori J. Bernstein, Catherine M. Sabiston, Jennifer M. Jones, Linda Trinh
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Abstract

Background Cancer-related cognitive impairment (CRCI) is a common, persistent quality of life complaint among breast cancer survivors (BCS), however there remain no proven treatments. There is emerging evidence that aerobic exercise and yoga may improve CRCI. There remains limited research on the safety and feasibility of virtually-supervised, remotely-delivered yoga interventions among cancer survivors, and no yoga studies to date have assessed cognitive function as a primary outcome in BCS. The purpose of this study was to explore the feasibility of an 8-week, remotely-delivered yoga intervention and examine its impact on cognitive function, fatigue, and exercise levels in BCS using a concurrent mixed-methods design. Methods Participants completed objective and self-report cognitive function measures (NIH Toolbox remote cognitive battery, PsyToolkit Task Switch test, Functional Assessment of Cancer Therapy-Cognitive Function [FACT-Cog3]); fatigue (Revised-Piper Fatigue Scale); and exercise activity level (modified Godin Leisure Time Exercise Questionnaire) before and after the yoga intervention. Semi-structured qualitative interviews were conducted post-intervention to understand participants' experiences with the yoga intervention, CRCI, and fatigue. Results The intervention surpassed a priori feasibility indicators (adherence rate = 83.7%, attrition rate = 5.4%, no adverse events). Participants ( n = 18, M age = 52.2 ± 10.1) had significant improvements in objective memory, fatigue, and weekly minutes of moderate-to-vigorous exercise post-intervention. Qualitative themes indicated that participants found the remote intervention to be enjoyable and beneficial. Conclusions In this small proof-of-concept study, remotely-delivered yoga appears safe and effective at improving CRCI. Future randomized controlled trials examining the impact of remotely-delivered yoga interventions on cognitive function in BCS are warranted.
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远程递送瑜伽干预乳腺癌幸存者认知功能的可行性:一项混合方法研究
癌症相关认知障碍(CRCI)是乳腺癌幸存者(BCS)中常见的、持续的生活质量抱怨,但目前还没有得到证实的治疗方法。越来越多的证据表明,有氧运动和瑜伽可以改善CRCI。在癌症幸存者中,关于虚拟监督、远程交付瑜伽干预的安全性和可行性的研究仍然有限,迄今为止还没有瑜伽研究将认知功能作为BCS的主要结局进行评估。本研究的目的是探讨为期8周的远程瑜伽干预的可行性,并使用并发混合方法设计检查其对BCS认知功能,疲劳和运动水平的影响。方法参与者完成客观认知功能和自述认知功能测试(NIH工具箱远程认知电池、PsyToolkit任务切换测试、癌症治疗功能评估-认知功能[FACT-Cog3]);疲劳(修订piper疲劳量表);瑜伽干预前后的运动活动水平(修正Godin休闲时间运动问卷)。干预后进行半结构化定性访谈,以了解参与者在瑜伽干预、CRCI和疲劳方面的经历。结果干预优于先验可行性指标(依从率为83.7%,损耗率为5.4%,无不良事件发生)。干预后,参与者(n = 18, M = 52.2±10.1)在客观记忆、疲劳和每周中高强度运动分钟数方面均有显著改善。定性主题表明,参与者发现远程干预是愉快和有益的。在这项小型概念验证研究中,远程瑜伽在改善CRCI方面安全有效。未来有必要进行随机对照试验,研究远程瑜伽干预对BCS认知功能的影响。
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