BackgroundFatigue is an important problem in paediatric cancer patients and yoga may be an effective intervention. The primary objective was to determine the feasibility of individualized yoga for hospitalized children receiving intensive chemotherapy.MethodsWe included English-speaking children and adolescents aged 7–18 years receiving intensive chemotherapy or haematopoietic stem cell transplantation (HSCT). Yoga was conducted three times weekly for three weeks. The primary outcome was feasibility, defined as ability to deliver at least 60% of planned sessions. Secondary outcomes were parent-reported Pediatric Quality of Life Inventory (PedsQL) Multidimensional Fatigue Scale, Fatigue Scale-Parent, PedsQL Generic Core Scales and PedsQL Acute Cancer Module.ResultsBetween January and October 2013, 11 patients were enrolled. Median age was 14.0 (range 7.7-16.4) years and 6 (55%) were boys. Yoga was feasible with 10/11 participants meeting the threshold for feasibility. The median number of yoga sessions was 9 (range 3–13). No adverse events were attributed to yoga. Mean ± standard deviation for the day 21 proxy-reported PedsQL general fatigue scores was 55.6 ± 15.5. Qualitative comments suggested design changes for future yoga studies.ConclusionsIndividualized yoga is feasible for inpatient children receiving intensive chemotherapy. Future work will include development and conduct of a randomized trial for fatigue amelioration.Trial registrationClinicalTrials.gov NCT02105389.

Purpose Objectives of this systematic review were to summarize how fatigue has been described from the perspective of children and adolescents with cancer, the impact of fatigue on quality of life, and child reported contributing factors and potential alleviators of fatigue. Methods We conducted electronic searches of Ovid Medline, EMBASE, PsycInfo, Science Citation, Social Science Citation (Web of Science), and CINAHL. We included studies of children and adolescents with cancer in which the experience of fatigue was described by the child/adolescent. The search was restricted to publications in English. Themes were summarized. Results Eleven studies were represented in 18 publications. Ages of included children ranged from 6 to 19 years. Majority of studies used semi-structured interviews to elicit participant's perceptions of fatigue. Terms used to describe fatigue included the following: tiredness, weary, loss of strength, dizziness, feeling drained, feeling drowsy, lacking motivation, exhaustion, and feeling emotional. Impact of fatigue related to not being able to participate in regular activities; needing to sleep or rest more; and impact on psychosocial health. Perceived alleviators of fatigue included exercise, distraction, rest, eating, and drinking. Conclusions Fatigue is impactful from the perspective of children and adolescents. Future research should focus on prospective exploration of the impact of fatigue on pediatric cancer patients and identifying approaches to reduce fatigue.