Clinical Bottom Line
“How should I apply this information?”
Living with cancer and the effects of treatment can be one of the most difficult things a child (and his or her family) can ever face. Quality of life can be poor and discouraging with side effects of these treatments including both physical and psychological deterioration. The suggestion that an intervention such as the Bendy Kids Yoga may offer hope and improved quality of life is encouraging. In addition, guidelines on exercise prescription for children hospitalized during cancer treatments are limited making this pilot study timely and promising. Exercise can have a positive effect on function, especially when patients are motivated to participate and perceive exercise to be beneficial. In this study, patients' perception of gross motor function demonstrated a significant improvement (according to quality-of-life measure: PedsQL) after participation in 5 yoga sessions. Including yoga in the plan of care for children hospitalized with cancer may offer clinicians another option to consider. As the authors describe, the actual yoga exercises/activities would need to be individualized because of age and medical status, and clinicians would need training to use this intervention.
“What should I be mindful about in applying this information?”
In a systematic review of the therapeutic effects of yoga,1 this form of exercise, being of low impact and relatively safe, was found to be a valuable treatment modality for many individuals; however, studies of children hospitalized for cancer treatment were not included in the review because they did not exist. Although this pilot study does show emerging evidence to support a similar conclusion for children with cancer, the reader needs to be cautious when applying these study results to clinical practice for several reasons. Unfortunately, as the authors point out, there were methodological limitations in their study including a small sample size, lack of a control group, and variability in the actual yoga activities undertaken. In addition, the length of intervention (5 sessions) was very short, there was a wide range of patient ages (5 to 15 years), lack of physical/functional outcome measures, and no long-term follow-up. Other confounding issues include the fact that other therapies (music, occupational therapy, physical therapy) were happening at the same time the yoga intervention was taking place, making it difficult to determine what led to the improved score on the PedsQL.
Deborah Nervik, PT, MHS, DPT, DHS, PCS
Franklin Pierce University, Concord, New Hampshire
Rachel L. Kongshaug, PT, MPT, PCS
Discovery Therapy, Phoenix, Arizona
1. Galantino ML, Galbavy R, Quinn L. Therapeutic effects of yoga for children: a systematic review of the literature. Pediatr Phys Ther. 2008;20(1):66–80.