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Yoga versus iPad active control for fatigue in paediatric cancer therapy: a randomised controlled trial
Tal Schechter1, Cassandra Tardif-Theriault2, Nicole Culos-Reed3
1Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Individualized yoga did not significantly reduce general fatigue in children undergoing intensive chemotherapy. However, yoga improved cognitive fatigue and cognitive problems in these young patients.
Area of Science:
- Pediatric Oncology
- Integrative Medicine
- Clinical Trials
Background:
- Cancer treatment, including chemotherapy, often leads to significant fatigue in pediatric patients.
- Managing treatment-related side effects like fatigue is crucial for improving quality of life in children with cancer.
Purpose of the Study:
- To evaluate the effectiveness of individualized yoga in reducing fatigue among hospitalized children receiving intensive chemotherapy.
- To compare the impact of yoga versus an iPad control on various fatigue measures.
Main Methods:
- A multicenter randomized controlled trial involving pediatric patients (aged 8-18) undergoing intensive chemotherapy.
- Participants were randomized to receive individualized yoga or an iPad intervention for 21 days, 5 days/week.
- The primary outcome was guardian-reported general fatigue using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS) at day 21.
Main Results:
- The trial closed early with 125 participants enrolled. No significant difference in general fatigue was observed between the yoga and iPad groups.
- Yoga intervention led to significant improvements in cognitive fatigue and cognitive problems compared to the control group.
- No significant differences were found in sleep/rest fatigue or systemic opioid administration between the groups.
Conclusions:
- The efficacy of individualized yoga for general fatigue in pediatric cancer patients undergoing intensive chemotherapy remains uncertain.
- Individualized yoga demonstrated a significant benefit in improving cognitive fatigue and addressing cognitive problems in this population.
Objectives:
The primary objective was to determine if individualised yoga for hospitalised children receiving intensive chemotherapy was associated with less fatigue using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS) compared with iPad control.
Methods:
This was a multicentre randomised controlled trial of individualised yoga in paediatric patients aged 8-18 years who were inpatients receiving intensive chemotherapy for leukaemia, lymphoma or haematopoietic cell transplantation. Participants were randomised to yoga or iPad groups; allocated programme was delivered individually by trained yoga instructors 5 days/week for 21 days. The primary outcome was day 21 guardian-reported general fatigue using the PedsQL MFS. Secondary outcomes included day 21 PedsQL sleep/rest and cognitive fatigue, Fatigue Scale and PedsQL Acute Cancer Module, and systemic opioid administration.
Results:
The study was closed early for poor accrual when 125/210 planned participants had been enrolled and randomised to yoga (n=62) or iPad (n=63). Guardian-reported PedsQL MFS general fatigue scores on day 21 were not significantly different between groups (adjusted difference 7.2, 95% CI -2.6 to 16.9) in favour of yoga. However, day 21 cognitive fatigue (adjusted difference 9.0, 95% CI 0.9 to 17.1), cognitive problems (adjusted difference 11.2, 95% CI 3.5 to 19.0) and communication (adjusted difference 10.6, 95% CI 0.8 to 20.4) were significantly better in the yoga compared with the iPad group. There were no significant differences in the other secondary outcomes including PedsQL sleep/rest fatigue (adjusted difference 4.9, 95% CI -3.5 to 13.3).
Conclusions:
The effect of individualised yoga on general fatigue is uncertain in paediatric patients receiving intensive chemotherapy. However, yoga significantly improved cognitive fatigue and cognitive problems.
Trial Registration Number:
NCT02134782.
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