Supportive Care in Cancer

, Volume 27, Issue 10, pp 3769–3776 | Cite as

A feasibility study examining the impact of yoga on psychosocial health and symptoms in pediatric outpatients receiving chemotherapy

  • Eliana Stein
  • Meera Rayar
  • Upasana Krishnadev
  • Abha Gupta
  • Shannon Hyslop
  • Erin Plenert
  • Tal Schechter-Finkelstein
  • Lillian SungEmail author
Original Article



Pediatric cancer patients experience symptoms that negatively impact quality of life; yoga may be an effective intervention. The primary objective was to determine the feasibility of a 10-week, weekly individualized yoga intervention for children and adolescents receiving outpatient cancer therapy primarily delivered remotely using Skype. Secondary objectives were to describe depression, anxiety, anger, fatigue, quality of life, and symptoms at 5 and 10 weeks after enrollment.


We included English-speaking patients aged 10 to 18 years receiving outpatient chemotherapy for cancer. Weekly individualized yoga sessions were offered for 10 weeks. Weeks 1, 5, and 10 were in-hospital while the remaining sessions were delivered remotely using Skype. Twice weekly, homework was assigned between each session. The primary outcome was feasibility, defined as 80% of participants completing at least 60% of planned in-hospital or remote yoga sessions.


Between March and November 2017, 10 patients were enrolled. Two patients discontinued the study after one and two sessions. Only six participants achieved at least 60% of planned yoga sessions and thus, the study did not meet the a priori defined feasibility threshold. Among all participants, only one homework session was performed.


A 10-week individualized in-person and remotely conducted yoga intervention was not feasible in children receiving cancer treatments because of failure to achieve the desired frequency of yoga sessions in a sufficient number of participants. Future research should identify approaches to improve compliance with remote yoga sessions and home practice.

Trial registration



Pediatric oncology Chemotherapy Yoga therapy Yoga Symptoms 



the Patient-Reported Outcomes Measurement Information System


Pediatric Quality of Life


Multidimensional Fatigue Scale


Symptom Screening in Pediatrics Tool


Research Electronic Data Capture


Statistical Analysis Software


Interquartile range



We wish to thank the volunteer yoga instructors, Robin Hurlow and Jeff Goodman, for sharing their time and expertise with the participants involved in this study.

Funding information

Funding from this study was provided by the Pediatric Oncology Group of Ontario (POGO) Seed Funding Grant.

Compliance with ethical standards

Ethical approval

Research Ethics Board approval was obtained from SickKids (REB#1000054681). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflicts of interest

There are no financial or non-financial conflicts of interest for any of the authors involved in this study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Program in Child Health Evaluative Sciences, The Hospital for Sick ChildrenPeter Gilgan Centre for Research and LearningTorontoCanada
  2. 2.Department of PediatricsUniversity of British ColumbiaVancouverCanada
  3. 3.Division of Child & Youth Mental Health, Department of PsychiatryUniversity of TorontoTorontoCanada
  4. 4.SickKids Centre for Community Mental HealthTorontoCanada
  5. 5.Division of Haematology/OncologyThe Hospital for Sick ChildrenTorontoCanada

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