Effect of yoga on symptom response in paediatric brain tumour inpatients undergoing chemo and radio therapy.

Abstract

Author(s): Govardhan HB, Noopur Nelson, Ibrahim Khaleel, Arun Kumar, Manisha Roy, Divyashree SJ, Harshitha KR, Anup Hegde

Introduction: Children subjected to either radiation therapy or chemotherapy for brain tumours; suffer from short term and long term effects leading to notable restriction in physical activity and mobility due to fatiguei. The above factors result in an overall depletion in quality of lifeii. Efforts to localise an intervention within the hospital premises to provide a child friendly supportive therapy to address the issue of QOL has to be undertaken. Yoga can be implemented as a low intensity physical activity. The objective of this study is to establish the feasibility and therapeutic effect of yoga in paediatric brain tumour and to provide a foundation for the development of a RCT. Materials and Methodology: 20 potential participants, aged between 6-18 years, planned for either radiation or chemotherapy for brain tumours were screened during commencement of their treatment from the in-patient department. 18 consented to the program with a written consent signed by the parent/guardian. A basic yoga module consisting of set of loosening, breathing, postures, relaxation and meditation was administered for 1 hour over 4 weeks. The primary outcome, feasibility, was defined as the ability to deliver a minimum of three sessions weekly (total - 5).Percentile of attendance will be calculated. A parent proxyreported feedback form, administered at baseline and at end of 4 weeks with an open ended question to assess willingness to continue the practice at home post discharge. Items are rated on a 4 point Likert scale from 0 (never) to 4 (a lot). Simple paired sample t test was used with Graph Pad online software for analysis. Results: The mean age of the group was found to be 9.8yrsAll participants achieved minimum required attendance. The median number of sessions attended was 16 with range of 12. Good acceptability of the program has been established. Extremely significant difference was seen with respect to reduction in appreciation of Pain ( 0.0001), Relief in headache (0.0005), increase in appetite ( 0.0005), better sleep (0.0003), reduced fatigue (0.007). Increase in overall daily activity was also significant with p=0.0018. The above result shows sufficient evidence to establish the positive effects of yoga. No other adverse event which can be attributed to the practice of yoga occurred. Conclusion: Individualized yoga is feasible for children with cancer receiving intensive chemo and radiotherapy thereby supporting its therapeutic benefit. A RCT to confirm the findings with larger sample size will help establish the outcome results.

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