Yoga effectively reduces fatigue and symptoms of depression in patients with different types of cancer

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ORIGINAL ARTICLE

Yoga effectively reduces fatigue and symptoms of depression in patients with different types of cancer Teresa Zetzl 1

&

Agnes Renner 1 & Andre Pittig 2,3 & Elisabeth Jentschke 1 & Carmen Roch 1 & Birgitt van Oorschot 1

Received: 23 July 2020 / Accepted: 18 September 2020 # The Author(s) 2020

Abstract Purpose Examine the effects of an 8-week yoga therapy on fatigue in patients with different types of cancer. Methods A total of 173 cancer patients suffering from mild to severe fatigue were randomly allocated to yoga intervention (n = 84) (IG) versus waitlist control group (CG) (n = 88). Yoga therapy consisted of eight weekly sessions with 60 min each. The primary outcome was self-reported fatigue symptoms. Secondary outcomes were symptoms of depression and quality of life (QoL). Data were assessed using questionnaires before (T0) and after yoga therapy for IG versus waiting period for CG (T1). Results A stronger reduction of general fatigue (P = .033), physical fatigue (P = .048), and depression (P < .001) as well as a stronger increase in QoL (P = .002) was found for patients who attended 7 or 8 sessions compared with controls. Within the yoga group, both higher attendance rate and lower T0-fatigue were significant predictors of lower T1-fatigue (P ≤ .001). Exploratory results revealed that women with breast cancer report a higher reduction of fatigue than women with other types of cancer (P = .016) after yoga therapy. Conclusion The findings support the assumption that yoga therapy is useful to reduce cancer-related fatigue, especially for the physical aspects of fatigue. Women with breast cancer seem to benefit most, and higher attendance rate results in greater reduction of fatigue. Trial registration German Clinical Trials Register DRKS00016034 Keywords Yoga . Complementary alternative medicine . Mind-body intervention . Fatigue . Depression . Quality of life

Background The overall survival rate in cancer is rising steadily due to better early detection and treatment options [1]. Therefore, not only the treatment itself but also side effects of cancer and its treatment are gaining more and more attention. Cancer-related fatigue is one of the most common side effects of cancer, which is perceived by patients as even more distressing than pain [2]. Fatigue is characterized by an intense and chronic sense of * Teresa Zetzl [email protected] 1

Interdisciplinary Center, Palliative Medicine, University Hospital Würzburg, Josef-Schneider-Str. 11, B1, 97080 Würzburg, Germany

2

Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany

3

Center of Mental Health, University of Würzburg, Würzburg, Germany

tiredness that is not associated with previous stress and cannot completely be eliminated by rest. On the physical level, fatigue expresses as tiredness and lack of bodily strength, on the emotional level as demotivation and depressed mood, and on the cognitive level as difficulty concentrating. It considerably reduces the q