title: A randomized controlled bicenter trial of yoga for patients with colorectal cancer.
abstract: OBJECTIVE
  The aim of this trial was to evaluate the effects of yoga on health-related quality of life in patients with colorectal cancer.
  
  
  METHODS
  Patients with non-metastatic colorectal cancer were randomly assigned to a 10-week yoga intervention (90 min once weekly) or a waitlist control group. Primary outcome measure was disease-specific quality of life (Functional Assessment of Cancer Therapy - Colorectal [FACT-C]) at week 10. Secondary outcome measures included FACT-C subscales: spiritual well-being (FACT - Spirituality); fatigue (FACT - Fatigue); sleep disturbances (Pittsburgh Sleep Quality Inventory); depression and anxiety (Hospital Anxiety and Depression Scale); body awareness (Scale of Body Connection); and body-efficacy expectations (Body-Efficacy Expectations Scale). Outcomes were assessed at week 10 and week 22 after randomization.
  
  
  RESULTS
  Fifty-four patients (mean age 68.3 ± 9.7 years) were randomized to yoga (n = 27; attrition rate 22.2%) and control group (n = 27; attrition rate 18.5%). Patients in the yoga group attended a mean of 5.3 ± 4.0 yoga classes. No significant group differences for the FACT-C total score were found. Group differences were found for emotional well-being at week 22 (∆ = 1.59; 95% CI = 0.27,2.90; p = 0.019), sleep disturbances at week 22 (∆ = -1.08; 95% CI = -2.13, -0.03; p = 0.043), anxiety at week 10 (∆ = -1.14; 95% CI = -2.20, -0.09; p = 0.043), and depression at week 10 (∆ = -1.34; 95% CI = -2.61, -0.8; p = 0.038). No serious adverse events occurred in the yoga group, while liver metastases were diagnosed in one patient in the control group.
  
  
  CONCLUSIONS
  This randomized trial found no effects of yoga on health-related quality of life in patients with colorectal cancer. Given the high attrition rate and low intervention adherence, no definite conclusions can be drawn from this trial.
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Cramer
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
authors.forename: Bijay
authors.initials: B
authors.lastname: Pokhrel
authors.affiliation: Tempelhof Colon Centre, St. Joseph's Hospital, Berlin, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Fester
authors.affiliation: Department of Surgery and Centre for Minimal Invasive Surgery, Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Meier
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.|Department of Pain Management, Krankenhaus St. Josef, Wuppertal, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Gass
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
authors.forename: Romy
authors.initials: R
authors.lastname: Lauche
authors.affiliation: Department of Community Health, National University, San Diego, CA, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Eggleston
authors.affiliation: Department of Surgery and Centre for Minimal Invasive Surgery, Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Walz
authors.affiliation: Department of Internal and Complementary Medicine, Immanuel Hospital Berlin, Berlin, Germany.|Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Centre, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Michalsen
authors.affiliation: Tempelhof Colon Centre, St. Joseph's Hospital, Berlin, Germany.
authors.forename: Reiner
authors.initials: R
authors.lastname: Kunz
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
authors.forename: Gustav
authors.initials: G
authors.lastname: Dobos
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.|Department of Integrative Gastroenterology, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
authors.forename: Jost
authors.initials: J
authors.lastname: Langhorst
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000628:therapy; D015179:Colorectal Neoplasms / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000628:therapy; D005221:Fatigue / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D019122:Meditation; D008875:Middle Aged; D011788:Quality of Life; D020377:Self Efficacy; D016896:Treatment Outcome; D015013:Yoga