Abstract
ObjectiveTo examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life.MethodologyOne hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2).ResultA significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B = − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54).ConclusionWeekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.
Highlights
Detection and treatment of cancer have significantly improved, leading to increased survival time in cancer patients
Between T1 and T2, no significant differences were found on any of the scales (p > 0.35). This randomized controlled trial examined the efficacy of reminder e-mails on yoga practice and fatigue in oncological patients with different types of cancer
Yoga for reducing fatigue is well-evaluated in cancer patients, but findings on the long-term effects of yoga are rare [17, 18, 41, 42]
Summary
Detection and treatment of cancer have significantly improved, leading to increased survival time in cancer patients. Individual documentation of the daily exercise duration in addition to the exercise CD was proven to be helpful concerning the sustainability of positive effects [17] These methods aim to establish regular yoga exercises, they are usually offered only once at the end of the yoga therapy, and due to a lack of regularity and frequency, they do not represent a reminder of the yoga practice. The fourth research question addressed the long-term changes in self-reported fatigue, depression, and quality of life after an 8-week yoga intervention for patients with different types of cancer after 6 months. We hypothesized that fatigue would be significantly lower immediately after yoga therapy and at the follow-up 6 months later compared to the baseline
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