Cohen, L., Warneke, C., Fouladi, R. T., Rodriguez, M. A., & Chaoul-Reich, A. (2004). Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer, 100, 2253–2260.

There were two groups:

1. Yoga intervention group (n = 20) 
2. Wait-list control group (n = 19). 

Randomization was performed using minimization.

Yoga sessions consisted of exercises in controlled breathing, visualization, and mindfulness with Tsa lung and Trul khor poses. Patients attended seven weekly sessions with a Tibetan yoga instructor. Written materials were provided.

• The sample was comprised of eight patients with lymphoma receiving CHOP or similar chemotherapy within 12 months posttreatment.
• Patients were predominantly female and posttreatment.
• Mean age was 51 years.
• Race and ethnicity were not reported.
• Patients were excluded if they had a psychotic illness.

• Outpatient
• Large specialized cancer center
• Classes were conducted at a Wellness Center.

Patients were undergoing the active treatment and long-term follow-up phases of care.

The study was a randomized, clinical trial.

• Brief Fatigue Inventory (BFI)
• Distress:  Impact of Events Scale (IES)
• Anxiety:  State-Trait Anxiety Inventory (STAI) 
• Depression:  Center for Epidemiologic Studies Depression scale (CESD)
• Sleep disturbances:  Pittsburgh Sleep Quality Index (PSQI) 
• Measures were taken at baseline and follow-up:  posttest and one week, one month, and three months later.

No significant differences were found in fatigue.

• The study had a small sample size.
• There was a possible floor effect because the scores were low.
• The adherence rate was variable.
• Timing of the measure may be a significant confounding factor because the study included patients both on and off treatment.
• A trained Tibetan Yoga instructor was required for the delivery of the intervention.