Pilot randomized, controlled trial of a dyadic yoga program for glioma patients undergoing radiotherapy and their family caregivers

Abstract

Background While the use of behavioral medicine in managing glioma patients’ symptoms is not well studied, the high symptom burden in patients and their family caregivers is well established. We conducted a pilot randomized, controlled trial to examine the feasibility and preliminary efficacy of a dyadic yoga (DY) intervention as a supportive care strategy. Methods Glioma patients undergoing radiotherapy and their caregivers were randomized to a 12-session DY or waitlist control (WLC) group. Prior to radiotherapy and randomization, both groups completed measures of cancer-related symptoms (MD Anderson Symptom Inventory-Brain Tumor module), depressive symptoms (Center for Epidemiological Studies-Depression measure), fatigue (Brief Fatigue Inventory), and overall quality of life (QOL; Medical Outcomes Study 36-item short-form survey). Dyads were reassessed at the last day of radiotherapy. Results Twenty patients (mean age: 46 years, 50% female, 80% WHO grade IV and caregivers (mean age: 50 years, 70% female, 50% spouses) participated in the trial. A priori feasibility criteria were met regarding consent (70%), adherence (88%), and retention (95%) rates. Controlling for relevant covariates, change score analyses revealed clinically significant improvements for patients in the DY compared with the WLC group for overall cancer symptom severity (d = 0.96) and symptom interference (d = 0.74), depressive symptoms (d = 0.71), and mental QOL (d = 0.69). Caregivers in the DY group reported clinically significant improvements in depressive symptoms (d = 1.12), fatigue (d = 0.89), and mental QOL (d = 0.49) relative to those in the WLC group. Conclusion A DY intervention appears to be a feasible and beneficial symptom and QOL management strategy for glioma patients undergoing radiotherapy and their caregivers. An efficacy trial with a more stringent control group is warranted. Clinical Trial Number NCT02481349

Physical activity and exercise in adults diagnosed with primary brain cancer: a systematic review

“…Seven studies almost exclusively included patients with high-grade glioma (HGG) (WHO grade III/IV) [ 19 , 21 , 22 , 25 – 28 , 30 ]. Other studies included mixed samples of low-grade glioma (LGG; WHO grade I/II) and HGG [ 16 – 18 , 20 , 23 , 24 , 29 , 31 ], involving newly diagnosed brain cancer [ 19 , 21 , 24 – 27 , 30 ] or recurrent brain cancer [ 22 , 25 , 28 ] (three articles did not specify [ 20 , 29 , 31 ]).…”

“…Nine studies (seven involving newly diagnosed patients [ 16 – 18 , 21 , 26 , 30 , 31 ]) evaluated the effect of an exercise intervention on cancer-related outcomes in patients with brain cancer (Table 3 ). These included three case-reports [ 21 , 25 , 30 ], three pre-post intervention studies (n: 5–24) [ 16 , 18 , 26 ], one case–control study (n = 43) [ 17 ] and two RCTs (n: 20–34) [ 20 , 29 , 31 ]. The case-reports related to three patients on treatment [ 21 , 25 , 30 ] and one post-treatment [ 25 , 30 ].…”

“…The case-reports related to three patients on treatment [ 21 , 25 , 30 ] and one post-treatment [ 25 , 30 ]. Two studies evaluated exercise post-surgery (during inpatient rehabilitation) [ 16 , 17 ], three studies during radiation and/or concurrent chemotherapy [ 18 , 26 , 31 ], and one evaluated exercise a minimum of 6-months post-treatment (surgery and/or adjuvant chemotherapy and/or radiotherapy) [ 20 , 29 ]. The number of studies that evaluated any given outcome (objectively-assessed or patient-reported) ranged between one and six studies (Table 4 ).…”

“…Intervention studies included patients with grade I–IV disease (although most [ 17 , 21 , 25 , 26 , 30 ] involved patients with HGGs only), five studies included mixed Gliomas (e.g. astrocytoma, glioblastoma) [ 16 , 18 , 20 , 25 , 29 , 31 ] and four studies involved glioblastoma only [ 17 , 21 , 26 , 30 ]. Except for one case-report describing an 87-week intervention, the intervention period ranged from 4 to 24 weeks.…”

Understanding the Impact of Patients’ Disease Types on Caregiving Time and Caregiver Burden: An Analysis of the Health Information National Trends Survey

“…Findings suggest though tailored and generic interventions both have potential to decrease caregivers' anxiety and depression symptoms, tailored interventions are more likely to induce sustained long-term health improvements in caregivers [66]. Evidence further indicates that dyad-based interventions can often take account of both patients' and caregivers' characteristics and preferences, and therefore have greater potential in improving patients and caregivers' coping skills and health outcomes than interventions designed solely for patients or caregivers [70][71][72]. Overall, ndings of this study ll considerable gaps in the literature and offer critical insights that could help further the research eld.…”