***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Women who develop secondary arm lymphoedema subsequent to treatment associated with breast cancer require life-long management for a range of symptoms including arm swelling , heaviness , tightness in the arm and sometimes the chest , upper body impairment and changes to a range of parameters relating to quality of life . While exercise under controlled conditions has had positive outcomes , the impact of yoga has not been investigated . The aim of this study is to determine the effectiveness of yoga in the physical and psycho-social domains , in the hope that women can be offered another safe , holistic modality to help control many , if not all , of the effects of secondary arm lymphoedema . Methods and design A r and omised controlled pilot trial will be conducted in Hobart and Launceston with a total of 40 women receiving either yoga intervention or current best practice care .  Intervention will consist of eight weeks of a weekly teacher-led yoga class with a home-based daily yoga practice delivered by DVD . Primary outcome measures will be the effects of yoga on lymphoedema and its associated symptoms and quality of life . Secondary outcome measures will be range of motion of the arm and thoracic spine , shoulder strength , and weekly and daily physical activity . Primary and secondary outcomes will be measured at baseline , weeks four , eight and a four week follow up at week twelve . Range of motion of the spine , in a self-nominated group , will be measured at baseline , weeks eight and twelve . A further outcome will be the women ’s perceptions of the yoga collected by interview at week eight . Discussion The results of this trial will provide information on the safety and effectiveness of yoga for women with secondary arm lymphoedema from breast cancer treatment . It will also inform methodology for future , larger trials . Trial registration This study examined the effect of an integrated yoga programme on chemotherapy-related nausea and emesis in early operable breast cancer out patients . Sixty-two subjects were r and omly allocated to receive yoga ( n = 28 ) or supportive therapy intervention ( n = 34 ) during the course of their chemotherapy . Both groups had similar socio-demographic and medical characteristics . Intervention consisted of both supervised and home practice of yoga sessions lasting for 60 min daily , while the control group received supportive therapy and coping preparation during their hospital visits over a complete course of chemotherapy . The primary outcome measure was the Morrow Assessment of Nausea and Emesis ( MANE ) assessed after the fourth cycle of chemotherapy . Secondary outcomes included measures for anxiety , depression , quality of life , distressful symptoms and treatment-related toxicity assessed before and during the course of chemotherapy . Following yoga , there was a significant decrease in post-chemotherapy-induced nausea frequency ( P = 0.01 ) and nausea intensity ( P = 0.01 ) , and intensity of anticipatory nausea ( P = 0.01 ) and anticipatory vomiting ( P = 0.05 ) as compared with the control group . There was a significant positive correlation between MANE scores and anxiety , depression and distressful symptoms . In conclusion , the results suggest a possible use for stress reduction interventions such as yoga in complementing conventional antiemetics to manage chemotherapy-related nausea and emesis OBJECTIVES This study compares the effects of an integrated yoga program with brief supportive therapy in breast cancer out patients undergoing adjuvant radiotherapy at a cancer centre . METHODS Eighty-eight stage II and III breast cancer out patients were r and omly assigned to receive yoga ( n = 44 ) or brief supportive therapy ( n = 44 ) prior to their radiotherapy treatment . Intervention consisted of yoga sessions lasting 60 min daily while the control group was imparted supportive therapy once in 10 days . Assessment s included European Organization for Research in the Treatment of Cancer- Quality of Life ( EORTCQoL C30 ) functional scales and Positive and Negative Affect Schedule ( PANAS ) . Assessment s were done at baseline and after 6 weeks of radiotherapy treatment . RESULTS An intention to treat GLM repeated measures ANOVA showed significant difference across groups over time for positive affect , negative affect and emotional function and social function . There was significant improvement in positive affect ( ES = 0.59 , p = 0.007 , 95%CI 1.25 to 7.8 ) , emotional function ( ES = 0.71 , p = 0.001 , 95%CI 6.45 to 25.33 ) and cognitive function ( ES = 0.48 , p = 0.03 , 95%CI 1.2 to 18.5 ) , and decrease in negative affect ( ES = 0.84 , p<0.001 , 95%CI -13.4 to -4.4 ) in the yoga group as compared to controls . There was a significant positive correlation between positive affect with role function , social function and global quality of life . There was a significant negative correlation between negative affect with physical function , role function , emotional function and social function . CONCLUSION The results suggest a possible role for yoga to improve quality of life and affect in breast cancer out patients BACKGROUND Physical activity provides a number of physical and psychological benefits to cancer survivors , including lessening the impact of detrimental cancer-related symptoms and treatment side-effects ( e.g. fatigue , nausea ) , and improving overall well-being and quality of life . The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer survivors . METHOD Eligible participants ( per-screened with PAR-Q/PAR-MED-X ) were r and omly assigned to either the  intervention ( n=20 ) or control group ( n=18 ) . All participants completed pre- and post-testing assessment s immediately before and after the yoga program , respectively . RESULTS The yoga program participants ( M age=51.18 ( 10.33 ) ; 92 % female ) included primarily breast cancer survivors , on average 55.95 ( 54.39 ) months post-diagnosis . Significant differences between the intervention and the control group at post-intervention were seen only in psychosocial ( i.e. global quality of life , emotional function , and diarrhea ) variables ( all p 's < 0.05 ) . There were also trends for group differences , in the hypothesized directions , for the psychosocial variables of emotional irritability , gastrointestinal symptoms , cognitive disorganization , mood disturbance , tension , depression , and confusion ( all p 's < 0.10 ) . Finally , there were also significant improvements in both the program participants and the controls from pre- to post-intervention on a number of physical fitness variables . CONCLUSIONS These initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors . Future research might attempt to include a broader range of participants ( e.g. other types of cancer diagnoses , male subjects ) , a larger sample size , and a longer program duration in an RCT To investigate prevalence and severity of symptoms and symptom clustering in breast cancer survivors who attended MBSR(BC ) .  Women were r and omly assigned into MBSR(BC ) or Usual Care ( UC ) . Eligible women were ≥ 21 years , had been diagnosed with breast cancer and completed treatment within 18 months of enrollment . Symptoms and interference with daily living were measured pre- and post-MBSR(BC ) using the M.D. And erson Symptom Inventory . Symptoms were reported as highly prevalent but severity was low . Fatigue was the most frequently reported and severe symptom among groups . Symptoms clustered into 3 groups and improved in both groups . At baseline , both  MBSR(BC ) and the control groups showed similar mean symptom severity and interference ; however , after the 6-week post-intervention , the MBSR(BC ) group showed statistically-significant reduction for fatigue and disturbed sleep ( P < 0.01 ) and improved symptom interference items , compared to the control group . For the between-group comparisons , 11 of 13 symptoms and 5 of 6 interference items had lower means in the MBSR(BC ) condition than the control condition . These results suggest that MBSR(BC ) modestly decreases fatigue and sleep disturbances , but has a greater effect on the degree to which symptoms interfere with many facets of life . Although these results are preliminary , MBSR intervention post-treatment may effectively reduce fatigue and related interference in QOL of breast cancer survivors OBJECTIVES The purpose of this pilot study was to gather information on the immediate and short-term effects of relaxation training according to the Yoga In Daily Life ( ® ) system on the self-esteem of patients with breast cancer . DESIGN This is a parallel-groups design . SETTING S/LOCATION Baseline interventions took place at the Institute for Oncology of Ljubljana ( Slovenia ) . At discharge , the experimental group was issued with audiocassette recordings containing the instructions for relaxation training to be practice d individually at home for an additional 3 weeks . SUBJECTS The convenience sample of 32 patients with breast cancer was recruited from an accessible population of hospitalized women . Patients were r and omized to the experimental ( n=16 ) and to the control group ( n=16 ) . INTERVENTIONS Both groups received the same st and ard physiotherapy for 1 week , while the experimental group additionally received a group relaxation training sessions according to the Yoga in Daily Life ( ® ) system . At discharge , the experimental group was issued with audiocassette recordings containing similar instructions for relaxation training to be practice d individually at home for an additional 3 weeks . OUTCOME MEASURES Outcome measures were obtained by blinded investigators ( physiotherapists ) using st and ardized question naires ( Rosenberg Self-Esteem Scale ) at baseline ( after the surgery ) ; at 1 week ( 1 week postattendance ; at discharge ) ; and at 4 weeks ( 4 weeks postattendance ) ; prior the commencement of radiation . RESULTS Analysis of variance showed that there were statistically significant differences between the experimental and control group in all measuring self-esteem scores over the study period ( p<0.0005 ) . At the same time , the control group 's scores remained unchanged over the study period ( p>0.05 ) . CONCLUSIONS The results indicate that relaxation training according to the Yoga in Daily Life system could be a useful clinical physiotherapy intervention for patients who have breast cancer and who are experiencing low self-esteem . Although this kind of relaxation training can be applied to clinical oncology in Slovenia , more studies need to be done 8505 Background : Yoga , an ancient Indian science , incorporates stress-reduction techniques that include regulated breathing , visual imagery , and meditation , as well as various postures that may be useful for cancer patients . METHODS A yoga program was developed that including loosening and breathing exercises , postures , alternate nostril breathing , a deep relaxation technique , and meditation for patients with breast cancer who were undergoing radiotherapy . Women participated in bi-weekly classes during their 6 weeks of radiation treatment . Sixty-one women with breast cancer were r and omly assigned to either the yoga program or to a waitlist control group . Patients completed measures of intrusive thoughts and avoidance behaviors ( Impact of Events Scale : IES ) , depressive symptoms ( CES-D ) , sleep disturbances ( Pittsburgh Sleep Quality Index ) , fatigue ( BFI ) , and quality of life ( SF-36 ) at baseline , 1 week , and 1 and 3 months after the last radiation therapy . We report on the outcomes 1 week after the end of radiotherapy . RESULTS The average age of the women was 52 , 3 % stage 0 , 28 % stage I , 43 % stage II , and 26 % stage III , 48 % had undergone breast-conserving surgery , and 75 % had received chemotherapy prior to starting radiotherapy . Analysis of covariance , controlling for baseline , revealed that the yoga group had significantly better SF-36 physical function scores ( adjusted means : yoga 81.8 vs. control 68.6 , P < 0.01 ) , significantly higher SF-36 general health scores ( adjusted means : yoga 78.3 vs. control 67.9 , P < 0.03 ) , marginally better SF-36 social functioning scores ( adjusted means : yoga 85.3 vs. control 76.0 , P > 0.1 ) , significantly lower levels of sleep-related daytime dysfunction ( adjusted means : yoga 0.5 vs. control 1.2 , P < 0.04 ) , and marginally lower levels of fatigue ( adjusted means : yoga 1.9 vs. control 3.1 , P < 0.06 ) than the control group . There were no other group differences on the SF-36 subscales or for the CES-D or IES scores . CONCLUSIONS The results indicated that the yoga program was associated with statistically and clinical significant improvements in aspects of quality of life . No significant financial relationships to disclose Approximately one-third of breast cancer survivors experiences persistent fatigue for months or years after successful treatment completion . There is a lack of evidence -based treatments for cancer-related fatigue , particularly among cancer survivors . This single-arm pilot study evaluated the feasibility and preliminary efficacy of a yoga intervention for fatigued breast cancer survivors based on the Iyengar tradition . Iyengar yoga prescribes specific poses for individuals with specific medical problems and conditions ; this trial emphasized postures believed to be effective for reducing fatigue among breast cancer survivors , including inversions and backbends performed with the support of props . Twelve women were enrolled in the trial , and 11 completed the full 12-week course of treatment . There was a significant improvement in fatigue scores from pre- to post-intervention that was maintained at the 3-month post-intervention followup . Significant improvements were also observed in measures of physical function , depressed mood , and quality of life . These results support the acceptability of this intervention and suggest that it may have beneficial effects on persistent post-treatment fatigue . However , results require replication in a larger 
    Output:
    
Comparing yoga groups to control groups , there was a statistically significant difference in overall health-related quality of life , depression , anxiety and gastrointestinal symptoms .
Meta-regression analyses revealed that the duration of yoga practice and type of control group partly explained the heterogeneity .
Subgroup analyses revealed that yoga had a positive effect on anxiety only when it had been practice d for longer than 3 months .
Only the wait-list control group showed an effect of yoga on physical well-being .
The current evidence demonstrates that yoga practice could be effective in enhancing health and managing some treatment-related side effects for patients recovering from breast cancer .