Virtual yoga (vYOCAS) intervention for psychological distress: A decentralized digital randomized controlled trial with cancer survivors.

Abstract

12131 Background: Psychological distress is highly prevalent among cancer survivors, and it interferes with their ability to recover after treatment and resume normal life activities. Yoga is a promising therapy that may reduce psychological distress and facilitate optimal recovery for survivors. However, accessibility can be limited for survivors who have higher risks of infection due to immunosuppression or high travel burden. Virtual delivery of yoga may increase accessibility for survivors. Methods: We conducted a decentralized, digital, phase II randomized controlled trial (RCT) examining the efficacy of virtual yoga compared to usual care for improving psychological distress among survivors. Participants were cancer survivors who completed primary treatment (e.g., surgery, chemotherapy, radiation therapy) within the last 2-60 months. Participants were randomized to receive virtual yoga or usual care. The Zoom platform was used to virtually deliver the Yoga for Cancer Survivors (vYOCAS) intervention. vYOCAS is a 4-week intervention based on gentle Hatha and restorative yoga. Each yoga session was delivered by a certified yoga instructor in small groups (2-4 survivors/group) for 75 minutes, twice a week. Psychological distress was assessed via the Profile of Mood States (POMS) at baseline and post-intervention. POMS evaluated tension-anxiety, depression, anger-hostility, fatigue, confusion, and overall mood. T-tests and ANCOVAs with baseline as a covariate were used to evaluate within- and between-group changes, respectively. Results: 42 survivors (93% female; mean age 58.5±11.6 years; 60% breast cancer; 17% residing in small town/underserved areas) were randomized and completed the study. On average, participants attended 6.2 of 8 prescribed yoga sessions. 44% of vYOCAS participants reported additional home practice of 62.8 minutes over 4 weeks. vYOCAS participants reported significant decreases in psychological distress (tension-anxiety: -1.5±0.6; depression: -1.2±0.4; fatigue: -2.4±0.7; overall mood: -7.3±2.4; all p < 0.05) at post-intervention. Usual care participants did not demonstrate similar improvements. ANCOVA results also revealed that vYOCAS participants experienced significantly greater improvements in fatigue (-2.1±0.8, p = 0.02) and overall mood (-6.4±3.1, p = 0.04) compared to usual care participants. No intervention-related adverse events were reported and the majority of survivors would recommend virtual yoga to others. Conclusions: vYOCAS is safe, feasible, and amenable for cancer survivors. vYOCAS may also significantly improve psychological distress.Clinicians should consider recommending virtual yoga therapy for survivors with psychological distress to overcome barriers related to accessibility. Future phase III decentralized digital RCTs are needed to confirm these findings. Clinical trial information: NCT04458194 .