Is yoga effective for improving fatigue among women with breast cancer?
Date of publication of the randomized controlled trial: September 2014
Design
Randomized controlled trial (RCT).
Participants
60 women aged 20 to 70 years with non-metastatic stages 1-3 of breast cancer and performed breast cancer surgery at least 1 month prior participated (mean age: 49.27 years).
Intervention
A twice-per-week yoga exercise program which was designed by yoga instructors and rehabilitation teachers was used as intervention. Each session was 60 minute in duration and it included warm-up, Anusara yoga, gentle stretching and relaxation exercises.
Comparator
Comparison: Yoga versus standard care. Standard care referred to receiving an introduction to the theoretical foundations of relaxation and ‘body-mind connectedness’.
Major Outcomes
Outcome 1: Fatigue level as assessed by 9-item Brief Fatigue Inventory (Taiwan version) with higher values indicating higher fatigue at week 8;
Outcome 2: Influence of fatigue on patients’ daily lives as assessed by 9-item Brief Fatigue Inventory (Taiwan version) with higher values indicating greater impact of fatigue on daily life at week 8.
Settings
This study was performed in an outpatient setting.
Comparison    Yoga versus standard care
Main Results
Compared to standard care, women with breast cancer had lower overall fatigue and fewer interference of fatigue in everyday life at week 8 in yoga group.
Comparison: Yoga versus standard care in women with breast cancer
Outcomes No. of studies (Total number of participants) Mean value (SD)/No. of participants Heterogeneity test (I2) MD (95% CI) Overall quality of evidence*
Intervention Comparator
1 1 (60) 10.9 (6.9)/ 30 20.4 (5.0)/ 30 Not applicable as there is only 1 study. Not reported Moderate
2 1 (60) 15.5 (13.3)/ 12 25.1 (9.1)/ 30 Not applicable as there is only 1 study. Not reported Moderate
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Comparison    Yoga versus standard care
Main Results
Compared to standard care, women with breast cancer had lower overall fatigue and fewer interference of fatigue in everyday life at week 8 in yoga group.
Comparison: Yoga versus standard care in women with breast cancer
Outcomes 1 2
No. of studies (Total number of participants) 1 (60) 1 (60)
Mean value (SD)/No. of participants Intervention 10.9 (6.9)/ 30 15.5 (13.3)/ 12
Comparator 20.4 (5.0)/ 30 25.1 (9.1)/ 30
MD (95% CI) Not reported Not reported
Overall quality of evidence* Moderate Moderate
Keys: SD = standard deviation; MD = mean difference; CI = confidence interval.
Conclusion
Benefits
Compare to standard care, the 8-week yoga exercise program showed lower overall fatigue and fewer interference of fatigue in everyday life among patients with breast cancer. For all outcomes, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
The authors did not report details of adverse events.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/25111109
The synopsis is based on the following article:
Taso, C. J., Lin, H. S., Lin, W. L., Chen, S. M., Huang, W. T., & Chen, S. W. The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: a randomized controlled trial. Journal of Nursing Research, Sep 2017; 22(3), 155-164.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.