Yoga for Promoting Health and Engagement After Breast Cancer Among African-American Women

The purpose of this research is to test the effects of a yoga-based exercise group on indicators of psychological and physical function among African-American women who have breast cancer history. Yoga is expected to positively affect psychological and physical functioning. This preliminary proposal, which reflects four of six intervention sessions, will focus on balance and upper-extremity functional use.

The study is one of the first to propose a yoga-based exercise group with African-American women who have breast cancer history. There is just one study published in the oncology literature (Moadel et al., 2007). African-American women carry more allostatic load (stress-related disease risk) than White women (Parente, Hale, & Palermo, 2012). Cancer history may have a greater affect on biomarkers associated with higher future disease risk among this population.

This pilot study has a quasi-experimental design. The intervention is six yoga-based group sessions using postures to target problems associated with breast cancer. Four of 6 sessions were complete as of this writing.

Participants are 20 African-American women from a large Midwestern city who have had breast cancer. They were recruited from organizations and events within the African-American community.

Data were collected with numerous objective measures and survey instruments. This proposal is limited to data from the Functional Reach Test, QuickDASH, Short Form Health Survey, and a health history.

Descriptive analysis was performed with baseline data. Preliminary outcomes analyzed at the study’s midpoint were determined with matched t tests. Further change analysis will be completed with analysis of variance testing and will include data from all relevant baseline measurement tools.

Preliminary results include attendance (76%), demographic, health, and functional change data. Women are an average of 60 yr old (standard deviation [SD] = 10) and are a mean 5 yr post–breast cancer diagnosis (SD = 4.7), staged I to III. Group frequency of comorbid disease is concerning: cardiac disease (60%), diabetes (20%), and depression (30%). Self-reported health, with the exception of emotional health, was significantly worse (p = .01), when compared with Short Form Health Survey normative values from Ware, Kosinski, and Keller (1994). Balance has significantly improved (p < .001) since baseline and now exceeds normative safety criterion. Upper-extremity functional use has improved but has not reached significance.

Findings corroborate evidence of a relatively higher level of health risk factors in African-American women who have had breast cancer (Parente, Hale, & Palermo, 2012). Physical function is improving, building capacity for safe engagement in functional physical activity and exercise. Early indications appear to support yoga as a health-promoting intervention.

Increasingly, occupational therapy practitioners and their clients are looking toward complementary medicine for interventions to support health. This study contributes to evidence for incorporating yoga into conventional occupational therapy practice.

References

Moadel, A., Shah, C., Wylie-Rosett, J., Harris, M., Patel, S., Hall, C., & Sparano, J. (2007). Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: Effects on quality of life. Journal of Clinical Oncology, 25, 4387–4395. http://dx.doi.org/10.1200/JCO.2006.06.6027

Parente, V., Hale, L., & Palermo, T. (2013). Association between breast cancer and allostatic load by race: National Health and Nutrition Examination Survey 1999–2008. Psycho-Oncology, 22, 621–628. http://dx.doi.org/10.1002/pon.3044

Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical and mental summary scales: A user’s manual. Boston: Health Institute.