Effects of a yoga-based stress reduction intervention on stress, psychological outcomes and cardiometabolic biomarkers in cancer caregivers: A randomized controlled trial

Abstract

Caregiving stress is a risk factor for cardiometabolic disease. Therefore, integrating cardiometabolic biomarkers into caregiving research provides a more comprehensive assessment of an individual’s health and response to an intervention. The objective of this study was to examine the effects of a yoga-based stress reduction intervention on stress, psychological outcomes, and cardiometabolic biomarkers in cancer caregivers. This prospective randomized controlled trial enrolled family caregivers of adult patients who underwent an allogeneic HSCT at the National Institutes of Health (NIH) Clinical Center. All subjects received usual care education. Participants in the intervention group received an Iyengar yoga intervention self-administered over six weeks using an audio recording file. The primary outcome was perceived stress (measured using the NIH toolbox Perceived Stress). The secondary outcomes were psychological factors (depression and anxiety measured using PROMIS® Depression and Anxiety), and cardiometabolic biomarkers measured by nuclear magnetic resonance spectroscopy. A total of 50 family caregivers (mean [SD] age, 44.9 [15.2] years; 42 [84.0%] women) were randomized, 25 to the intervention group and 25 to the control group. No group differences were noted in stress, depression, and anxiety. Significant interaction effects between group and time were found in large TRL-P (F(1,43) = 10.16, p = 0.003) and LP-IR (F(1,42) = 4.28, p = 0.045). Post-hoc analyses revealed that the levels of large TRL-P (mean difference = 1.68, CI = [0.86, 2.51], p< .001) and LP-IR (mean difference = 5.67, CI = [1.15, 10.18], p = 0.015) significantly increased over time in the control group but while remained stable in the intervention group (mean difference = -0.15, CI = [-0.96, 0.66], p = 0.718; mean difference = -0.81, CI = [-5.22, 3.61], p = 0.714, respectively). Even when perceptions of psychological distress remain unchanged, incorporating gentle yoga poses and breathing exercises may reduce the risk of cardiometabolic disease in caregivers by inhibiting the development of insulin resistance. Standard lipids of cardiometabolic risk do not appear to be robust enough to detect short-term early changes of cardiometabolic risk in caregivers. Trial registration: ClinicalTrials.gov Identifier: NCT02257853.

Nature-based virtual reality intervention to manage stress in family caregivers of allogeneic hematopoietic stem cell transplant recipients: a two-phase pilot study protocol

“…We used a two-sided hypothesis that the stress level will differ between Active VR group and Sham VR group. In order to detect a difference between Active VR group and Sham VR group, we will need 39 caregiver participants in each group and a total sample size of 78 based on an effect size of 0.6 and correlation of 0.80 between two time points from our previous stress reduction study ( 54 ), with 80% power and type 1 error of 0.05. To account for a 20% attrition rate, this study will enroll up to 94 caregivers.…”

Bibliometric Analysis of Randomized Controlled Trials on Yoga Interventions for Cancer Patients: A Decade in Review

“…However, there is a notable disparity in research focus toward cancer types such as colon [26], glioma [52,53], hematological malignancies [25,37], head and neck [16,19], and lung cancer [35], with each category having only one or two studies. The "mixed" category has 14 trials [20,28,33,36,40,44,46,48,49,54,55,57,67,73], which suggests an investigative interest in the general applicability of yoga interventions across different types of cancer rather than site-specific effects. Pediatric [66] and prostate cancer [29,50] are represented with one and two trials, respectively, pointing to emerging, yet still limited, research within these patient populations (Figure 4).…”

Associations among NMR-measured inflammatory and metabolic biomarkers and accelerated aging in cardiac catheterization patients

“…Finally, we also examined NMR measures of LDL and HDL as secondary outcomes, as these outcomes have not been examined for individuals with underlying cardiovascular disease [32][33][34].…”