Patient-Reported Outcomes from an App-Delivered Yogic Breathing when Compared to Mindfulness in Post-Radiation Therapy in Breast Cancer Survivors: A Randomized Controlled Trial.

With high survival rates of 91% and 85% at 5 and 10 years, breast cancer survivors face a myriad of physical and psychological challenges, and urgent measures are needed to improve their survivorship. Breathing regulation is an easily accessible practice to address the altered physical and psychological demands of cancer survivors. A yogic breathing (YB) involving cyclic inhalation, breath-retention, and exhalation appears promising in managing symptoms and improving survivors' quality of life. Based on the anxiolytic properties of YB, we tested if YB could be delivered through an app and used in cancer survivorship. This clinical trial was conducted in an academic hospital in the USA between December 2021 and June 2023. Post-radiation therapy adult female breast cancer survivors (N = 40) referred by their radiation oncologists who completed radiation therapy within the past six months were recruited and randomized 1:1 to YB and MI groups. Participants received initial in-person training for YB, a nostril-specific timed inhalation, retention, and exhalation exercise, or MI, watching the thoughts without any cues to breathing regulation. A web app provided video guidance and group or solo practice options and captured practice times for 12 weeks. Behavioral Risk Factors Surveillance System Questionnaire was collected at the baseline. The primary outcomes were feasibility and acceptability of the intervention measured by app use (adherence), system usability scale (SUS), and qualitative exit interviews. Secondary outcomes included Patient-Reported Outcomes Measurement Information Systems (PROMIS), (PROMIS) scales of Sleep Disturbance (Short Form 4a), Emotional Distress – Anxiety (Short Form 8a), Emotional Distress – Depression (Short Form 8a), MD Anderson Symptom Inventory (MDASI), and perceived stress (PSS). Patient-reported assessments were performed on weeks 1 and 12. Participants had a median age of 56 (range = 34-79) years. Adherence and acceptability proportions of the app-delivered intervention were 0.2 (95% CI = -0.09, 0.36) and 0.6 (95% CI = -0.41, 0.77) respectively. There was a significant improvement in mean anxiety (-6.01 ± 1.58) and depression (-3.55 ± 2.81) in YB when compared to MI (-1.72 ± 1.56 for anxiety and -0.29 ± 2.57 for depression) post-intervention. Other outcomes showed moderate improvements in MI and YB. Qualitative exit interviews informed the intervention was beneficial and offered suggestions for program improvements. The accessible YB practice may help to manage key symptoms during cancer survivorship. The YB exercise may be a valuable tool for symptom management in breast cancer survivors and can be delivered through an app. Limitations include the fact that this study involves a small group of patients, and more extensive, fully powered studies are required to validate the findings further. ClinicalTrials.gov Identifier NCT05161260. [ABSTRACT FROM AUTHOR]