title: Intervention Protocol for Investigating Yoga Implemented During Chemotherapy.
abstract: OBJECTIVE
  Fatigue and other treatment-related symptoms are critical therapeutic targets for improving quality of life in patients with colorectal cancer during chemotherapy. Yoga is a promising intervention for improving these therapeutic targets and has been primarily investigated in the group-class format, which is less feasible for cancer patients with high symptom burden to attend. Thus, we developed a protocol for implementing yoga individually in the clinic among patients receiving chemotherapy.
  
  
  METHODS
  We followed recommended domains for developing a yoga protocol to be used in an efficacy trial. These recommendations include consideration to the style, delivery, components of the intervention, dose, specific class sequences, facilitation of home practice, measurement of intervention fidelity, selection of instructors, and dealing with modifications. The intervention protocol was developed by an interdisciplinary team.
  
  
  METHODS
  Yoga Skills Training (YST) consists of four 30-minute in-person sessions and was implemented while in the chair during chemotherapy infusions for colorectal cancer with recommended daily home practice for eight weeks. Therapeutic goals of the YST are to reduce fatigue, circadian disruption, and psychological distress. Elements of the YST are awareness meditation, gentle seated movement, breathing practice, and relaxation meditation. Attention, comfort, and ease are also highlighted.
  
  
  CONCLUSIONS
  This description of a protocol for integrating yoga with conventional cancer treatment will inform future study designs and clinical practice. The design of the YST is novel because it implements yoga-most commonly studied when taught to groups outside of the clinical setting- individually during clinical care.
authors: 1. Vanderbilt University School of Medicine, Nashville, TN.|2. Wake Forest University, School of Medicine, Department of Social Sciences & Health Policy, Winston-Salem, NC.
authors: Stephanie J
authors: SJ
authors: Sohl
authors: 1. Vanderbilt University School of Medicine, Nashville, TN.
authors: Gurjeet S
authors: GS
authors: Birdee
authors: 3. Vanderbilt University School of Nursing, Nashville, TN.
authors: Sheila H
authors: SH
authors: Ridner
authors: 4. California State University, Department of Kinesiology, San Bernardino, CA.
authors: Amy
authors: A
authors: Wheeler
authors: 1. Vanderbilt University School of Medicine, Nashville, TN.
authors: Sandra
authors: S
authors: Gilbert
authors: 5. Healing Yoga Foundation, San Francisco, CA.
authors: Danielle
authors: D
authors: Tarantola
authors: 1. Vanderbilt University School of Medicine, Nashville, TN.
authors: Jordan
authors: J
authors: Berlin
authors: 1. Vanderbilt University School of Medicine, Nashville, TN.
authors: Russell L
authors: RL
authors: Rothman
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000628:therapy; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D006801:Humans; D019122:Meditation; D011788:Quality of Life; D012119:Respiration; D015013:Yoga
chemical_list: D000970:Antineoplastic Agents
keywords: cancer; circadian disruption; fatigue; integrative medicine; mind-body therapy; psychological distress; stress