Galantino Mary Lou, Brooks Jennifer, Tiger Robyn, Jang Shera, Wilson Kim
Professor of Physical Therapy, Stockton University, Galloway, N.J.; University of Pennsylvania, Perelman School of Medicine, Philadelphia; and University of Witwatersrand, Johannesburg, South Africa.
Oncology Rehabilitation and Lymphedema Management, Bacharach Institute for Rehabilitation, Pomona, N.J.
Int J Yoga Therap. 2020 Jan 1;30(1):49-61. doi: 10.17761/2020-D-18-00030.
Chemotherapy-induced peripheral neuropathy (CIPN) causes significant pain and is an adverse effect of treatment with chemotherapeutic agents. We explored a somatic yoga and meditation intervention in a predominantly minority population. Goals included describing strategies for minority inclusion and testing feasibility and effectiveness. Eight individuals with CIPN enrolled in a single-arm feasibility trial. Somatic yoga and meditation were provided weekly for 8 weeks, with an additional home program component. The primary outcomes were Sit and Reach, Functional Reach, and Timed Up and Go. Secondary outcomes were Patient Neurotoxicity Questionnaire, FACT-GOG-Ntx (for addressing patient concerns associated with neurological symptoms), Brief Pain Inventory, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Falls Efficacy Scale. Sensitivity to vibration was measured via biothesiometer. Participants with a mean age of 65 (49-73) years self-reported as 63% African-American and 37% Caucasian. They attended 81% of the sessions, and no adverse events we re re p o rted. CIPN symptoms (FAC T- G O G - N t x ) improved significantly (from 88.88 to 106.88, standard deviation = 20.03; p = 0.039). Fear of falling improved, approaching significance (from 39.26 to 34.38, standard deviation = 6.081; p = 0.058). Other measures showed improvement trends, with a slight increase in Brief Pain Inventory pain severity (from 3.50 to 3.75, p = 0.041) possibly reflecting comorbidities. Four qualitative themes emerged: (1) CIPN symptom variability, with musculoskeletal comorbidities; (2) utility of learned skills; (3) improvement in self-confidence, balance, and stability; and (4) social support, with CIPN experience validation and increasing health literacy. Challenges of recruitment and retention require specific outreach, community trust, and health literacy. Preliminary data suggest that somatic yoga and meditation may affect fear of falling and quality of life in cancer survivors with CIPN. A randomized controlled trial using inclusive recruitment and retention methods is indicated to establish the intervention's efficacy.
化疗引起的周围神经病变(CIPN)会导致严重疼痛,是化疗药物治疗的一种不良反应。我们在一个以少数族裔为主的人群中探索了一种体式瑜伽和冥想干预措施。目标包括描述纳入少数族裔的策略,并测试可行性和有效性。八名患有CIPN的个体参加了一项单臂可行性试验。体式瑜伽和冥想每周进行一次,共持续8周,并附加家庭练习部分。主要结局指标为坐位体前屈、功能性前伸和计时起立行走测试。次要结局指标为患者神经毒性问卷、FACT-GOG-Ntx(用于解决与神经症状相关的患者担忧)、简明疼痛量表、感知压力量表、匹兹堡睡眠质量指数和跌倒效能感量表。通过生物感觉测量仪测量振动敏感性。平均年龄为65(49 - 73)岁的参与者自我报告为63%非裔美国人及37%白种人。他们参加了81%的课程,且未报告不良事件。CIPN症状(FACT-GOG-Ntx)显著改善(从88.88提高到106.88,标准差 = 20.03;p = 0.039)。对跌倒的恐惧有所改善,接近显著水平(从39.26降至34.38,标准差 = 6.081;p = 0.058)。其他测量指标显示出改善趋势,简明疼痛量表的疼痛严重程度略有增加(从3.50升至3.75,p = 0.041),这可能反映了合并症情况。出现了四个定性主题:(1)CIPN症状的变异性及肌肉骨骼合并症;(2)所学技能的实用性;(3)自信心、平衡能力和稳定性的改善;(4)社会支持,包括CIPN经历的验证和健康素养的提高。招募和留住参与者面临挑战,需要进行特定的外展活动、建立社区信任并提高健康素养。初步数据表明,体式瑜伽和冥想可能会影响患有CIPN的癌症幸存者对跌倒的恐惧和生活质量。需要进行一项采用包容性招募和留住参与者方法的随机对照试验,以确定该干预措施的疗效。