title: Development of an Individualized Yoga Intervention to Address Fatigue in Hospitalized Children Undergoing Intensive Chemotherapy.
abstract: Purpose Fatigue is an important problem in children receiving intensive chemotherapy and hematopoietic stem cell transplantation (HSCT). Exercise may be an effective intervention for fatigue. Individualized yoga represents an ideal intervention because it can be tailored according to an individual child's needs. Little is known about how to structure a standardized yoga program for intensivelytreated children. Therefore, this study describes the development of a yoga program and an approach to monitoring sessions suitable for hospitalized children receiving intensive chemotherapy or HSCT. Methods The yoga program was designed to increase mobility in hospitalized children and to provide children with relaxation techniques that could be used independently in a variety of environments. The program was founded on 4 key tenets: safety, adaptability, environmental flexibility, and appeal to children. We also developed quality and consistency assurance procedures. Results A menu format with a fixed structure was selected for the yoga program. Each yoga session contained up to 6 sections: breathing exercises, warmup exercises, yoga poses, balancing poses, cool-down poses, and final relaxation. Yoga instructors selected specific yoga poses for each session from a predetermined list organized by intensity level (low, moderate, or high). Monitoring procedures were developed using videotaping and multirater adjudication. Conclusion We created a standardized yoga program and an approach to monitoring that are now ready for incorporation in clinical trials. Future work should include the adaptation of the program to different pediatric populations and clinical settings.
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Diorio
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: Celis Ekstrand
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Tanya
authors.initials: T
authors.lastname: Hesser
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Cathy
authors.initials: C
authors.lastname: O'Sullivan
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lee
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Tal
authors.initials: T
authors.lastname: Schechter
authors.affiliation: The Hospital for Sick Children, Toronto, Ontario, Canada lillian.sung@sickkids.ca.
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001945:Breathing Exercises / Q000523:psychology; D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005221:Fatigue / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D019122:Meditation / Q000523:psychology; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012064:Relaxation Therapy / Q000379:methods; D015013:Yoga / Q000523:psychology*
chemical_list: D000970:Antineoplastic Agents
keywords: children; fatigue; pediatric oncology; program development; quality of life; yoga