Yoga for Fatigue in the Survivors of Bone Marrow Transplantation

OBJECTIVES

Primary Objective: To assess the feasibility of an organized yoga intervention for HCT survivors with CRF.

Hypothesis: A trial of yoga in the HCT survivor population will be deemed feasible if at least 75% of study subjects demonstrated protocol adherence rate of at least 80%.

Secondary Objectives:

• Explore participants' perceptions regarding yoga and physical activity

Hypothesis: HCT survivors will be positive about yoga and will express satisfaction with the yoga program, as will be shown during focus groups that will be held at the end of the yoga program.

• Evaluate the association between yoga practice and self-efficacy and self-regulation

Hypothesis: Adherence to yoga will be associated with higher self-efficacy and selfregulation scores.

• Evaluate the changes in CRF scores from baseline to the end of the yoga program.

Hypothesis: CRF scores at the end of the yoga program will be lower than CRF scores at baseline.

• Evaluate whether changes in CRF are associated with changes in depression, sleep disturbances, physical activity, and pain.

Hypothesis 5: Improvement in CRF will be associated with increased physical activity and decreased depression, sleep disturbances, and pain.

• Evaluate the safety of yoga practice in HCT survivors.

Hypothesis: Yoga will be considered as a safe intervention for CRF in HCT survivors as demonstrated by the absence of adverse events or serious adverse events related to or associated with yoga practice.

Inclusion criteria

• Adult HCT survivors as defined by being at least 100 days post autologous or allogeneic transplantation for a malignant disease. There is no restriction to enrollment by donor type, donor cell source, presence or absence of graft versus host disease.
• Age ≥ 18 years at the time of transplant.
• A history of persistent CRF as defined by a perception of general CRF for at least one month before enrollment.
• A history of at least moderate CRF as defined by a CRF score of 4 or more on a 10-point Visual Analog Scale.
• Participants who are deemed qualified for yoga movements according to the Yoga Qualifying Movements Screening Checklist (a checklist developed by researchers at the University of California, Los Angeles to promote yoga safety through assessing the eligibility of each patient)

Exclusion criteria

• A self-reported current practice of yoga or any other mind-body therapy, including but not limited to meditation or hypnosis therapy in the past 30 days prior to study enrollment.
• Subjects currently on supplemental oxygen support.
• Subjects currently receiving hemodialysis.
• Subjects currently admitted to an inpatient unit at Michigan Medicine.
• Subjects with an uncontrolled, active infection. Subjects with viremia (Cytomegalovirus or other) may be enrolled, provided they are on active therapy and at the discretion of the treating physician.
• Subjects who have relapsed after their autologous or allogeneic transplant.