STUDY SUMMARY: Restorative Yoga for Women with Breast Cancer

Source: Psycho-oncology, 18(4): 360-368. April 2009.
Authors: Danhauer SC, Mihalko SL, Russell GB, Campbell CR, Felder L, Daley K, & Levine EA.
Contact: Suzanne C. Danhauer, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157-1082. danhauer@wfubmc.edu.

This study examined the effects of group restorative yoga classes on emotional and physical well-being in women with breast cancer.

44 women with breast cancer (34% still undergoing cancer treatment; mean age of 55.8 ± 9.9 years) were randomly assigned to either the yoga program or a wait-list control group. After the initial 10-week study period, the control group was offered the full yoga program.

The yoga program consisted of 10 weekly 75-minute restorative yoga classes at a local studio, with class size ranging from 3-12 students. The instructor was registered with the Yoga Alliance, had cancer-specific yoga training, and was a cancer survivor.

The classes included asanas (held from 20 seconds to 5 minutes, depending on the pose), pranayama, and deep relaxation in savasana. The principle of ahimsa (non-violence) was emphasized throughout the practice, and participants were encouraged to take care of themselves and modify poses based on their own needs. Most poses could be practiced either in a chair or on a yoga mat, and the teacher offered props to help students become more comfortable. In each pose, the teacher reminded students to breathe.

The researchers provided the following list of practices and postures that were practiced in every class:
(1) centering and meditation (conscious, deep breathing, mental inventory of body, energy, thoughts, and emotions)(15 minutes)
(2) neck and shoulder series (move neck through range of motion, turning head side to
side, dropping ear to shoulder, chin to chest and eyes toward ceiling, roll shoulders forward and back, then squeeze shoulders to ears and release)(5 minutes)
(3) leg stretch (janu sirsasana variation) using a strap and circling ankles slowly in both directions (5 minutes)
(4) side bend (seated parighasana) (2 minutes)
(5) seated twist (ardha matsyandrasana variation) (2 minutes)
(6) simple supported backbend (1–5 minutes)
(7) transition(resting pose to shift into another posture)
(8) legs up the wall (viparita karani or variation) (5 minutes)
(9) supported bound-angle pose (supta badha konasana variation) (5 minutes).

The following poses were in some but not all practices:
(1) mountain pose (tadasana)
(2) arm and shoulder stretch
(3) supported forward fold
(4) seated sun salutation (surya namaskar variation)
(5) reclining twist with a bolster

Researchers measured the following self-reported dimensions of well-being both before and after the 10-week study period: physical well-being, social/family well-being, mental/emotional well-being (including symptoms of depression), functional well-being, spiritual well-being, and other outcomes particularly relevant to cancer concerns, including sleep and fatigue.

Yoga participants, compared to control participants, reported better mental/emotional well-being, physical well-being, spritual well-being, sleep, and energy. The improvement in emotional well-being was strongest for women who entered with higher levels of negative emotions or depression, and the improvement in sleep quality was strongest for women who began the study with more sleep problems. Women attended an average of 5.8 out of the 10 classes (s.d. = 3.4). For both physical and functional well-being, number of classes attended predicted improvement. Participants reported that they enjoyed the classes, and no adverse events were reported.

This study demonstrated some of the most comprehensive benefits of yoga for cancer patients and survivors. Previous studies (by different research groups) have demonstrated benefits for sleep, energy, cancer symptoms, emotional well-being, and social well-being, but none have demonstrated such global positive outcomes. This study should be considered encouraging evidence supporting the use of yoga to support women with breast cancer. In addition, the researchers should be thanked and commended for providing such a detailed description of the yoga classes, allowing other researchers and yoga teachers to replicate or build on their program.

This research summary was orginally prepared for the International Association of Yoga Therapists. IAYT is a professional organization for yoga therapists, yoga teachers, researchers, and healthcare professionals who use yoga in their practice.