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A Randomized Trial of Yoga for Children Hospitalized With Sickle Cell Vaso-Occlusive Crisis
Karen Moody1, Bess Abrahams2, Rebecca Baker1
1Indiana University School of Medicine, Indianapolis, IN, USA.
Insights
Yoga significantly reduced pain in children experiencing vaso-occlusive crisis (VOC) due to sickle cell disease (SCD). This study shows yoga is a helpful, feasible intervention for hospitalized children with SCD pain.
Area of Science:
- Pediatric Hematology
- Complementary and Alternative Medicine
- Pain Management
Background:
- Vaso-occlusive crisis (VOC) is a common and painful complication of sickle cell disease (SCD) in children.
- Nonpharmacological interventions are recommended for pain management in SCD.
- Evidence for yoga's efficacy in pediatric VOC pain is limited.
Purpose of the Study:
- To compare the effect of yoga versus an attention control on pain in children with VOC.
- To assess the impact of yoga on anxiety, length of stay, and opioid use in pediatric VOC.
Main Methods:
- Children aged 5-21 with SCD hospitalized for uncomplicated VOC and severe pain were eligible.
- Participants were stratified by disease severity and randomized to a yoga or control group.
- Pain scores, anxiety, length of stay, and opioid use were compared between groups.
Main Results:
- Yoga significantly reduced mean pain scores compared to the control group after one session (P=0.029).
- No significant differences were observed in anxiety, length of stay, or opioid use between the yoga and control groups.
- Eighty-three percent of eligible patients enrolled, indicating feasibility.
Conclusions:
- Yoga is an acceptable, feasible, and beneficial intervention for hospitalized children with VOC.
- Further research is warranted to explore yoga's role in managing SCD pain in both inpatient and outpatient settings.
Context:
Sickle cell disease (SCD) vaso-occlusive crisis (VOC) remains an important cause of acute pain in pediatrics and the most common SCD complication. Pain management recommendations in SCD include nonpharmacological interventions. Yoga is one nonpharmacological intervention that has been shown to reduce pain in some populations; however, evidence is lacking in children with VOC.
Objectives:
The primary objective of this study was to compare the effect of yoga vs. an attention control on pain in children with VOC. The secondary objectives were to compare the effect of yoga vs. an attention control on anxiety, lengths of stay, and opioid use in this population.
Methods:
Patients were eligible if they had a diagnosis of SCD, were 5-21 years old, were hospitalized for uncomplicated VOC, and had an admission pain score of ≥7. Subjects were stratified based on disease severity and randomized to the yoga or control group.
Results:
Eighty-three percent of patients approached (N = 73) enrolled on study. There were no significant differences in baseline clinical or demographic factors between groups. Compared with the control group, children randomized to yoga had a significantly greater reduction in mean pain score after one yoga session (-0.6 ± 0.96 vs. 0.0 ± 1.37; P = 0.029). There were no significant differences in anxiety, lengths of stay, or opioid use between the two groups.
Conclusion:
This study provides evidence that yoga is an acceptable, feasible, and helpful intervention for hospitalized children with VOC. Future research should further examine yoga for children with SCD pain in the inpatient and outpatient settings.
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