Yoga as a Therapy for Adolescents and Young Adults with Cystic Fibrosis: A Pilot Study

Abstract

Rationale:Yoga has been shown to improve outcomes in patients with asthma but has not been investigated in cystic fibrosis (CF) patients.Methods:This was a prospective pilot study to evaluate the safety of a standardized yoga program among CF patients aged 12 to 25 years. Participants engaged in a 50-minute yoga session twice weekly for 8 weeks conducted by a certified yoga instructor using a standardized program designed to be safe for health-compromised individuals. Yoga sessions were individual to avoid transmission of infections. Primary outcome was safety and tolerability. Secondary outcome measures included respiratory symptoms, the Cystic Fibrosis Quality of Life instrument (CFQ-R), lung function, Ease of Breathing Score (measure of exercise tolerance), and weight.Results:Eleven participants were enrolled, and 10 completed the study. Adherence was very good; the mean (SD) number of sessions completed was 14.2 (1.3) out of 16 sessions. Eight patients reported 25 adverse events. The most common was cough, reported in 7. Two events were possibly related to study procedures: calf pain and headache. There were no significant changes in dyspnea or pain scales. The mean (SD) CFQ-R respiratory domain score increased from screening to end of study: 67.9 (11.4) to 82.1 (9.9), P=.04. There were no significant changes in the other outcome measures.Conclusions:In this pilot study, a standardized 8-week yoga program was safe and well tolerated among adolescent and young adult CF patients with mild to moderate lung disease. This study may be helpful to yoga instructors who are interested in working with CF patients. Larger controlled trials are warranted to determine further benefits.

Yoga Therapy in Children with Cystic Fibrosis Decreases Immediate Anxiety and Joint Pain

“…Twenty participants completed the yoga program offered at our site. As with Ruddy et al [76], the subjects in our study tolerated the yoga therapy safely.…”

“…After systematic review [75, 76] we found only one prior study performed by Ruddy et al to evaluate yoga as a complementary therapeutic practice in children with cystic fibrosis [76]. The study presented here is the largest to date and the first with a primary aim is to evaluate therapeutic benefit; however, this is a pilot study and the results should be considered suggestive but not conclusive.…”

“…The mean (SD) CFQ-R respiratory domain score increased significantly from screening to end of study, 67.9 (11.40 to 82.1 (9.9)), ( p = 0.04) in the 10 participants who completed the program. No other outcome measures reached significance and it was recommended that further testing with larger trials be conducted [76]. Twenty participants completed the yoga program offered at our site.…”

“…The respiratory subscale also did not show notable improvements ( p = 0.076) in our study. It is worth noting that the Ruddy et al study did show a significant improvement in the CFQ-R respiratory subscale in their ten-participant cohort ( p = 0.04) with a more intense session period (twice a week for 10 weeks), but they were also unable to show significant improvement in the emotion subscale ( p = 0.13) The Ruddy et al protocol was to practice yoga twice a week for 8 weeks and had a mean attendance of 14 sessions [76]. Larger controlled trials may be warranted to further investigate yoga and quality of life improvements in patients with CF, especially since yoga has been shown to increase quality of life scores in other chronic disease populations including breast cancer, rheumatoid arthritis, and children with hemophilia [40, 42, 51] as well as respiratory diseases such as asthma [79].…”

Review: Quality of Life in Children with Non-cystic Fibrosis Bronchiectasis

“…However, there was no significant change in the other domain scores: the self-reported respiratory symptom score, FEV 1 , weight, or Ease of Breathing Score. No studies have been done in NCFB ( 41 ).…”